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Link to original content: https://doi.org/10.1007/s11060-022-04160-y
Improving quality of life post-tumor craniotomy using personalized, parcel-guided TMS: safety and proof of concept | Journal of Neuro-Oncology Skip to main content

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Improving quality of life post-tumor craniotomy using personalized, parcel-guided TMS: safety and proof of concept

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Abstract

Purpose

Deficits in neuro-cognitive function are not uncommon for patients who have undergone surgical removal of brain tumors. Our goal is to evaluate the safety and efficacy of repetitive Transcranial Magnetic Stimulation (rTMS) as a non-invasive tool for the treatment of neuro-cognitive dysfunctions following craniotomy.

Methods

We present a retrospective review of individualized rTMS in twelve patients from Cingulum Health from December 2019 to July 2021 who presented with neuro-cognitive deficits following craniotomy. Multiple cortical targets were selected based on the patient’s neurological disorder, associated networks, and anomalies in the functional connectivity of the brain as determined by machine-learning. TMS treatment was performed for five consecutive days. EuroQol quality of life (EQ-5D), functional extremity scales, and neuropsychiatric questionnaires related to the patient’s deficit were assessed prior to, after, and during two-month follow-up of rTMS treatment.

Results

Nine patients had unilateral functional deficits in either upper, lower, or both limbs. One patient reported post-operative depression, another experienced short term memory difficulties, and a third reported hypobulia. All twelve patients reported significantly improved EQ5D after rTMS treatment and during follow-up. More than half of the patients with lower and upper functional deficits had a 9-point improvement during follow-up. In the patient who developed depression, an 88% reduction in depressive symptoms based on the Beck’s Depression Inventory (BDI) was observed during follow-up. No adverse events, such as seizures, occurred.

Conclusion

The personalized functional connectivity approach to rTMS treatment may be effective and safe for patients with post-craniotomy neuro-cognitive dysfunction.

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Data availability

Data is available upon request.

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Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Author information

Authors and Affiliations

  1. School of Medicine, 21772 University of California Davis Medical Center, 2315 Stockton Blvd., Sacramento, CA, 95817, USA

    Si Jie Tang

  2. University of Sydney, Camperdown, NSW, 2006, Australia

    Jonas Holle

  3. Cingulum Health, 2G Hayes Rd, Rosebery, Sydney, NSW, 2018, Australia

    Jonas Holle, Olivia Lesslar, Charles Teo, Michael Sughrue & Jacky Yeung

  4. Department of Neurosurgery, Yale University School of Medicine, PO Box 208082, New Haven, CT, 06520-8082, USA

    Jacky Yeung

  5. Omniscient Neurotechnology, Sydney, Australia

    Charles Teo & Michael Sughrue

Authors
  1. Si Jie Tang
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  2. Jonas Holle
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  3. Olivia Lesslar
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  4. Charles Teo
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  5. Michael Sughrue
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  6. Jacky Yeung
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Contributions

SJT: Formal Analysis, Writing—Original Draft; Writing—Review & Editing; Visualization. JH: Conceptualization; Methodology; Data Curation; Writing—Review & Editing; Visualization; Formal Analysis. OL: Conceptualization; Writing—Review & Editing. CT: Conceptualization; Writing—Review & Editing. MS: Conceptualization; Writing—Review & Editing. JY: Conceptualization; Methodology; Formal analysis; Writing—Review &Editing; Supervision. All authors have approved the final article.

Corresponding author

Correspondence to Jacky Yeung.

Ethics declarations

Conflict of interest

Charles Teo and Michael Sughrue are founders and employees of Omniscient Neurotechnology. Jonas Holle is an employee of Cingulum Health. Jacky Yeung and Olivia Lesslar are consultants of Cingulum Health but are not employees. Si Jie Tang does not report any conflicts of interest.

Ethical approval

This study was approved by the Human Research Ethics Committee of the South Eastern Sydney Local Health District (2022/ETH00139).

Consent to participate

Informed consent was obtained from all individual participants included in the study.

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Tang, S.J., Holle, J., Lesslar, O. et al. Improving quality of life post-tumor craniotomy using personalized, parcel-guided TMS: safety and proof of concept. J Neurooncol 160, 413–422 (2022). https://doi.org/10.1007/s11060-022-04160-y

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  • DOI: https://doi.org/10.1007/s11060-022-04160-y

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