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KMID : 0860920180200020106
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Journal of the Korean Association EMG-Electrodiagnostic Medicine
2018 Volume.20 No. 2 p.106 ~ p.111
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Localization of Bilateral Hemisphere Lesion Using Combined Transcranial Magnetic Stimulation and Diffusion Tensor Imaging: Report of Two Cases
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Lee Hyung-Nam
Oh Young-Bin
Kim Gi-Wook
Won Yu-Hui
Ko Myoung-Hwan
Seo Jeong-Hwan
Park Sung-Hee
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Abstract
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Transcranial magnetic stimulation (TMS) has been a gold standard for investigating central motor pathways in humans. Diffusion tensor imaging with fiber tractography (DTI FT) is known for its usefulness in detecting white matter lesion in vivo. We investigated the clinical usefulness of elucidating the integrity and continuity of corticospinal tract (CST) by combined use of TMS and DTI FT in this study. We report two cases who have presented with left hemiparesis and evaluated by both TMS and DTI FT; 10-year-old boy with Mitochondrial Encephalomyopathy with Lactic Acidosis and Stroke-like episode syndrome and 20-year-old woman with traumatic brain injury. Combined use of TMS and DTI FT successfully led to localize the brain lesion that might cause motor impairment in patients with abnormal signal intensities in MRI. The results of this study suggest that TMS and DTI FT might provide the detailed information between function and anatomy of the CST, complementarily.
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KEYWORD
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corticospinal tracts, dffusion tensor imaging, transcranial magnetic stimulation
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