Metastases to BrainMENTORNCT07415668
Motor Eloquent Navigated Transcranial Magnetic Stimulation for Radiosurgery Planning
A study testing Navigated Transcranial Magnetic Stimulation (nTMS) in people with Metastases to Brain, run by Insel Gruppe AG, University Hospital Bern at 1 site in Switzerland.
Trial summary
With this project, the study group wants to investigate whether a postoperative navigated transcranial magnetic stimulation (nTMS) motor map can improve stereotactic radiosurgery (SRS) planning in patients who underwent resection for a brain metastasis near the primary motor cortex. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Metastases to Brain
- What is being tested?
- Navigated Transcranial Magnetic Stimulation (nTMS)
- Type of treatment
- Medical device
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 30 participants
- Where
- 1 siteSwitzerland
- Study dates
- 8 May 2026to 31 Oct 2029
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Informed consent
- Age ≥ 18 years
- Cerebral metastasis within or adjacent to the primary motor cortex (≤10 mm)
- Resection of tumor
- Eligible for and planned to undergo postresection radiosurgery at Inselspital Bern
Who cannot join
- Contraindication to TMS (e.g. Cochlear Implant, other metallic or electrical implants, excluding teeth and post craniotomy, Meniere's disease, pacemaker, deep brain stimulation electrodes, refractory convulsion, symptomatic tinnitus, depression diagnosed by a specialist, psychosis)
- Prior cerebral radiation therapy within the affected precentral gyrus/affecting the planned SRS plan
- Planned whole brain radiotherapy
- Second lesion within 2 cm ipsilateral in the primary motor cortex
- Infection or difficulties in wound healing within the last two weeks prior inclusion
- Pregnancy
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
Switzerland1 site, 1 recruiting
- Recruiting
University Hostpital Bern, Department of Neurosurgery Bern
Bern, 3010
Kathleen Seidel, MD, +41316322409, kathleen.seidel@insel.ch
Katharina Lutz, MD, +41316322409, katharina.lutz@insel.ch
About this study
With this project, the study group wants to investigate whether a postoperative navigated transcranial magnetic stimulation (nTMS) motor map can improve stereotactic radiosurgery (SRS) planning in patients who underwent resection for a brain metastasis near the primary motor cortex. Specifically, the map could allow for more precise location of motor eloquent tissue, thereby minimizing the radiation dose on these areas while preserving high radiation dose on target tissue (i.e. tumor cells).
Read the detailed description
Background:
Radiation therapy is a cornerstone in the management of metastatic brain tumors. It is applied either as a first-line treatment or postoperatively to the resected tumor bed. Delivering a sufficiently high radiation dose to the lesion or tumor bed while preventing neurological deficits due to radionecrosis from overexposure of vulnerable healthy brain tissue remains particularly challenging in eloquent brain regions such as the motor cortex.
According to international guidelines (ICRU Reports 50, 62, and 83), target volumes for radiation therapy must be carefully defined, while organs at risk (OARs), including the optic apparatus, cochlea, hippocampus, brainstem, and pituitary gland, must be spared. The motor cortex (M1) and corticospinal tract (CST) should likewise be preserved; however, they are not formally defined as OARs in current guidelines, and their precise delineation is technically demanding.
The anatomical precentral gyrus ("anatomical M1") does not exactly correspond to the functional location of motor control ("functional M1"). Conventional imaging techniques such as functional MRI (fMRI) and diffusion tensor imaging (DTI) provide limited spatial accuracy, with localization errors of up to 1 cm. In contrast, navigated transcranial magnetic stimulation (nTMS) is a noninvasive method that identifies motor-eloquent regions based on individual MRI data, offering more accurate functional mapping for radiation treatment planning. This raises the question of whether integrating postoperative, pre-radiotherapy nTMS maps could enable more tailored and precise radiation therapy plans.
Previous studies have shown that nTMS demonstrates a median deviation of only 5.2 mm compared with direct cortical stimulation (the gold standard), whereas fMRI may deviate even more than 1 cm. Especially in patients with tumors involving the motor cortex, nTMS has been shown to provide superior spatial accuracy. Preliminary data further suggest that incorporating nTMS into radiotherapy planning may reduce radiation exposure to the motor cortex and CST while maintaining optimal target coverage.
However, published studies so far have relied exclusively on preoperative imaging. Postoperative anatomical changes, due to brain shift and variations in the resection cavity, can render these maps inaccurate for postoperative planning. It therefore remains to be determined whether updating nTMS maps using postoperative MRI obtained immediately before radiotherapy can enhance treatment precision and clinical outcomes.
Objective:
The objective of this study is to address the following questions in patients with resected brain metastases involving or adjacent to the motor cortex:
- Is it possible to simultaneously maintain the sufficient radiation dose in the region of the lesion and keep the dose on the functional primary motor area (M1) as low as possible?
- Does the integration of nTMS mapping into radio-oncological treatment planning and the associated dose reduction to M1 affect clinical outcomes?
- Is there a correlation between the final dose received by the functional M1 and the clinical/oncological outcome (post-radiosurgery motor function, radionecrosis and local tumor control at 3, 6- and 12-months follow-up)?
Methods:
The planning of SRS will be performed by a team of radiation oncologists at the Inselspital, Bern University Hospital with extensive experience in brain metastases treatment. Manual segmentations of the target volume and nTMS points will be performed. The included cases will be reviewed for the extent/dose of the treatment plan and two treatment plans will be created: a "standard" and an "nTMS-adapted" treatment plan.
For the "nTMS-adapted" plan, the nTMS motor map will be fused with the planning MRI. The motor map of each patient (regions of interest defined by the positive MEP responses) will be used to define "functional M1". The treatment dose will be prescribed to the planning target volume (Planning target volume (PTV): resection cavity plus any contrast enhancement with a 2 mm safety margin in patients with surgery). This plan will be optimized according to nTMS motor maps by reducing the dose applied to the motor eloquent tissue as low as reasonably possible by constraining the dose prescription in this area to 15 Gy in single fraction. PTV overlap with the motor maps will not be spared. The radiation oncologist selects the nTMS-adapted plan if it covers at least 95% of the target volume; otherwise, the standard plan is chosen to ensure adequate dose coverage.
- Conditions
- Metastases to Brain
- Being tested
- Navigated Transcranial Magnetic Stimulation (nTMS)
- Keywords
- metastasis, Navigated Transcranial Magnetic Stimulation (nTMS), Stereotactic Radiosurgery (SRS)
- Medical subject headings
- Brain Neoplasms, Neoplasm Metastasis
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Navigated Transcranial Magnetic Stimulation (nTMS)Device
Every patient will undergo a postoperative nTMS motor mapping, and both the "standard" and "nTMS-adapted" SRS plan will be created for every patient. The plan will be selected by the radiation oncologist, depending on whether at least 95% of the dose is administered to the target volume with the "nTMS-adapted" plan or not. Every patient then receives SRS.
| Study group | Role | What they receive |
|---|---|---|
| MENTOR | Experimental | Every patient will undergo a postoperative nTMS motor mapping, and both the "standard" and "nTMS-adapted" SRS plan will be created for every patient. The plan will be selected by the radiation oncologist, depending on whether at least 95% of the dose is administered to the target volume with the "nTMS-adapted" plan or not. Every patient then receives SRS. Receives: Device: Navigated Transcranial Magnetic Stimulation (nTMS) |
What is being measured
The primary outcome is the main question the study is designed to answer.
Within-patient difference in maximum dose
Within-patient difference in maximum dose (defined as the dose received by the most exposed 0.03 cc of the tissue) to functional M1 between the standard and nTMS-adapted SRS plans, provided that both plans achieve PTV coverage ≥95% and comply with standard organ-at-risk constraints
Measured: 5 to 2 days before SRS
Secondary outcomes (9)
Feasibility of plan selection
Proportion of patients in whom the nTMS-adapted plan is deliverable, defined as meeting PTV coverage ≥95% and standard OAR constraints
Measured: 5 to 2 days before SRS
Target coverage (%) of both plans
Target coverage in %
Measured: 5 to 2 days before SRS
Motor outcome
Motor outcome (MRCS score) of each patient, at the day of nTMS (as baseline), 3, 6 and 12 months after the first radiation session
Measured: At 3, 6 and 12 month follow-up
Motor outcome
Motor outcome (House and Brackman) of each patient, at the day of nTMS (as baseline), 3, 6 and 12 months after the first radiation session
Measured: At 3, 6 and 12 month follow-up
Motor outcome
Motor outcome (results of pegboard test) of each patient, at the day of nTMS (as baseline), 3, 6 and 12 months after the first radiation session
Measured: At 3, 6 and 12 month follow-up
Motor outcome
Motor outcome (foot tapping test) of each patient, at the day of nTMS (as baseline), 3, 6 and 12 months after the first radiation session
Measured: At 3, 6 and 12 month follow-up
tumor recurrence
recurrence (according to RANO) at 3, 6 and 12 months (yes/no) after first radiation
Measured: At 3, 6 and 12 month follow-up
Quality of life (EQ-5D-5L)
Quality of life via questionnaire (EQ-5D-5L)
Measured: At 3, 6, and 12 month follow-up
Presence of Radiation necrosis
Presence of Radiation necrosis in the precentral gyrus after 1 year.
Measured: At 12 month follow-up
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted17 Feb 2026
- Study start8 May 2026
- Primary completion30 Apr 2029 (estimated)
- Study completion31 Oct 2029 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (10)Papers the sponsor has linked to this study.
- Other trials for Metastases to BrainStudies of the same condition, open and under way.
- More trials run by Insel Gruppe AG, University Hospital BernThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Prevention
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Enrolment
- 30 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Insel Gruppe AG, University Hospital Bern
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07415668
- Sponsor's protocol ID
- MENTOR
- Acronym
- MENTOR
- Status last verified
- Aug 2026
- First submitted
- 29 Jan 2026
- Last updated
- 4 Aug 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Milano MT, Grimm J, Niemierko A, Soltys SG, Moiseenko V, Redmond KJ, Yorke E, Sahgal A, Xue J, Mahadevan A, Muacevic A, Marks LB, Kleinberg LR. Single- and Multifraction Stereotactic Radiosurgery Dose/Volume Tolerances of the Brain. Int J Radiat Oncol Biol Phys. 2021 May 1;110(1):68-86. doi: 10.1016/j.ijrobp.2020.08.013. Epub 2020 Sep 11.
PubMed 32921513Kondziolka D, Patel A, Lunsford LD, Kassam A, Flickinger JC. Stereotactic radiosurgery plus whole brain radiotherapy versus radiotherapy alone for patients with multiple brain metastases. Int J Radiat Oncol Biol Phys. 1999 Sep 1;45(2):427-34. doi: 10.1016/s0360-3016(99)00198-4.
PubMed 10487566Lin NU, Lee EQ, Aoyama H, Barani IJ, Barboriak DP, Baumert BG, Bendszus M, Brown PD, Camidge DR, Chang SM, Dancey J, de Vries EG, Gaspar LE, Harris GJ, Hodi FS, Kalkanis SN, Linskey ME, Macdonald DR, Margolin K, Mehta MP, Schiff D, Soffietti R, Suh JH, van den Bent MJ, Vogelbaum MA, Wen PY; Response Assessment in Neuro-Oncology (RANO) group. Response assessment criteria for brain metastases: proposal from the RANO group. Lancet Oncol. 2015 Jun;16(6):e270-8. doi: 10.1016/S1470-2045(15)70057-4. Epub 2015 May 27.
PubMed 26065612Rossi S, Hallett M, Rossini PM, Pascual-Leone A; Safety of TMS Consensus Group. Safety, ethical considerations, and application guidelines for the use of transcranial magnetic stimulation in clinical practice and research. Clin Neurophysiol. 2009 Dec;120(12):2008-2039. doi: 10.1016/j.clinph.2009.08.016. Epub 2009 Oct 14.
PubMed 19833552Schwendner MJ, Sollmann N, Diehl CD, Oechsner M, Meyer B, Krieg SM, Combs SE. The Role of Navigated Transcranial Magnetic Stimulation Motor Mapping in Adjuvant Radiotherapy Planning in Patients With Supratentorial Brain Metastases. Front Oncol. 2018 Oct 2;8:424. doi: 10.3389/fonc.2018.00424. eCollection 2018.
PubMed 30333959Strnad V, Sauer R. [Prostatic carcinoma]. Dtsch Med Wochenschr. 1994 Jul 29;119(30):1054-6. No abstract available. German.
PubMed 8050345Kamada K, Todo T, Masutani Y, Aoki S, Ino K, Takano T, Kirino T, Kawahara N, Morita A. Combined use of tractography-integrated functional neuronavigation and direct fiber stimulation. J Neurosurg. 2005 Apr;102(4):664-72. doi: 10.3171/jns.2005.102.4.0664.
PubMed 15871509Scoccianti S, Detti B, Gadda D, Greto D, Furfaro I, Meacci F, Simontacchi G, Di Brina L, Bonomo P, Giacomelli I, Meattini I, Mangoni M, Cappelli S, Cassani S, Talamonti C, Bordi L, Livi L. Organs at risk in the brain and their dose-constraints in adults and in children: a radiation oncologist's guide for delineation in everyday practice. Radiother Oncol. 2015 Feb;114(2):230-8. doi: 10.1016/j.radonc.2015.01.016. Epub 2015 Feb 17.
PubMed 25701297Hodapp N. [The ICRU Report 83: prescribing, recording and reporting photon-beam intensity-modulated radiation therapy (IMRT)]. Strahlenther Onkol. 2012 Jan;188(1):97-9. doi: 10.1007/s00066-011-0015-x. No abstract available. German.
PubMed 22234506Seidel K, Hani L, Lutz K, Zbinden C, Redmann A, Consuegra A, Raabe A, Schucht P. Postoperative navigated transcranial magnetic stimulation to predict motor recovery after surgery of tumors in motor eloquent areas. Clin Neurophysiol. 2019 Jun;130(6):952-959. doi: 10.1016/j.clinph.2019.03.015. Epub 2019 Apr 5.
PubMed 30981901
Study at a glance
From the registry record, last updated by the sponsor on 4 Aug 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Motor Eloquent Navigated Transcranial Magnetic Stimulation for Radiosurgery Planning
- ClinicalTrials.gov ID
- NCT07415668
- Acronym / sponsor ID
- MENTOR / MENTOR
- Conditions
- Metastases to Brain
- Keywords
- metastasis, Navigated Transcranial Magnetic Stimulation (nTMS), Stereotactic Radiosurgery (SRS)
- Study type
- Interventional
- Recruitment status
- Recruiting
- Enrolment
- 30 participants (estimated)
- Lead sponsor
- Insel Gruppe AG, University Hospital BernUniversity, hospital or other
- Study start
- 8 May 2026 (actual)
- Primary completion
- 30 Apr 2029 (estimated)
- Study completion
- 31 Oct 2029 (estimated)
- First posted
- 17 Feb 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
With this project, the study group wants to investigate whether a postoperative navigated transcranial magnetic stimulation (nTMS) motor map can improve stereotactic radiosurgery (SRS) planning in patients who underwent resection for a brain metastasis near the primary motor cortex. Specifically, the map could allow for more precise location of motor eloquent tissue, thereby minimizing the radiation dose on these areas while preserving high radiation dose on target tissue (i.e. tumor cells).
Detailed description
Background:
Radiation therapy is a cornerstone in the management of metastatic brain tumors. It is applied either as a first-line treatment or postoperatively to the resected tumor bed. Delivering a sufficiently high radiation dose to the lesion or tumor bed while preventing neurological deficits due to radionecrosis from overexposure of vulnerable healthy brain tissue remains particularly challenging in eloquent brain regions such as the motor cortex.
According to international guidelines (ICRU Reports 50, 62, and 83), target volumes for radiation therapy must be carefully defined, while organs at risk (OARs), including the optic apparatus, cochlea, hippocampus, brainstem, and pituitary gland, must be spared. The motor cortex (M1) and corticospinal tract (CST) should likewise be preserved; however, they are not formally defined as OARs in current guidelines, and their precise delineation is technically demanding.
The anatomical precentral gyrus ("anatomical M1") does not exactly correspond to the functional location of motor control ("functional M1"). Conventional imaging techniques such as functional MRI (fMRI) and diffusion tensor imaging (DTI) provide limited spatial accuracy, with localization errors of up to 1 cm. In contrast, navigated transcranial magnetic stimulation (nTMS) is a noninvasive method that identifies motor-eloquent regions based on individual MRI data, offering more accurate functional mapping for radiation treatment planning. This raises the question of whether integrating postoperative, pre-radiotherapy nTMS maps could enable more tailored and precise radiation therapy plans.
Previous studies have shown that nTMS demonstrates a median deviation of only 5.2 mm compared with direct cortical stimulation (the gold standard), whereas fMRI may deviate even more than 1 cm. Especially in patients with tumors involving the motor cortex, nTMS has been shown to provide superior spatial accuracy. Preliminary data further suggest that incorporating nTMS into radiotherapy planning may reduce radiation exposure to the motor cortex and CST while maintaining optimal target coverage.
However, published studies so far have relied exclusively on preoperative imaging. Postoperative anatomical changes, due to brain shift and variations in the resection cavity, can render these maps inaccurate for postoperative planning. It therefore remains to be determined whether updating nTMS maps using postoperative MRI obtained immediately before radiotherapy can enhance treatment precision and clinical outcomes.
Objective:
The objective of this study is to address the following questions in patients with resected brain metastases involving or adjacent to the motor cortex:
- Is it possible to simultaneously maintain the sufficient radiation dose in the region of the lesion and keep the dose on the functional primary motor area (M1) as low as possible?
- Does the integration of nTMS mapping into radio-oncological treatment planning and the associated dose reduction to M1 affect clinical outcomes?
- Is there a correlation between the final dose received by the functional M1 and the clinical/oncological outcome (post-radiosurgery motor function, radionecrosis and local tumor control at 3, 6- and 12-months follow-up)?
Methods:
The planning of SRS will be performed by a team of radiation oncologists at the Inselspital, Bern University Hospital with extensive experience in brain metastases treatment. Manual segmentations of the target volume and nTMS points will be performed. The included cases will be reviewed for the extent/dose of the treatment plan and two treatment plans will be created: a "standard" and an "nTMS-adapted" treatment plan.
For the "nTMS-adapted" plan, the nTMS motor map will be fused with the planning MRI. The motor map of each patient (regions of interest defined by the positive MEP responses) will be used to define "functional M1". The treatment dose will be prescribed to the planning target volume (Planning target volume (PTV): resection cavity plus any contrast enhancement with a 2 mm safety margin in patients with surgery). This plan will be optimized according to nTMS motor maps by reducing the dose applied to the motor eloquent tissue as low as reasonably possible by constraining the dose prescription in this area to 15 Gy in single fraction. PTV overlap with the motor maps will not be spared. The radiation oncologist selects the nTMS-adapted plan if it covers at least 95% of the target volume; otherwise, the standard plan is chosen to ensure adequate dose coverage.
Study design
- Primary purpose
- Prevention
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Number of arms
- 1
| Arm | Type | Receives |
|---|---|---|
| MENTOR | Experimental | Device: Navigated Transcranial Magnetic Stimulation (nTMS)Every patient will undergo a postoperative nTMS motor mapping, and both the "standard" and "nTMS-adapted" SRS plan will be created for every patient. The plan will be selected by the radiation oncologist, depending on whether at least 95% of the dose is administered to the target volume with the "nTMS-adapted" plan or not. Every patient then receives SRS. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (5 listed)
- Informed consent
- Age ≥ 18 years
- Cerebral metastasis within or adjacent to the primary motor cortex (≤10 mm)
- Resection of tumor
- Eligible for and planned to undergo postresection radiosurgery at Inselspital Bern
Key exclusion criteria (6 listed)
- Contraindication to TMS (e.g. Cochlear Implant, other metallic or electrical implants, excluding teeth and post craniotomy, Meniere's disease, pacemaker, deep brain stimulation electrodes, refractory convulsion, symptomatic tinnitus, depression diagnosed by a specialist, psychosis)
- Prior cerebral radiation therapy within the affected precentral gyrus/affecting the planned SRS plan
- Planned whole brain radiotherapy
- Second lesion within 2 cm ipsilateral in the primary motor cortex
- Infection or difficulties in wound healing within the last two weeks prior inclusion
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Navigated Transcranial Magnetic Stimulation (nTMS)Every patient will undergo a postoperative nTMS motor mapping, and both the "standard" and "nTMS-adapted" SRS plan will be created for every patient. The plan will be selected by the radiation oncologist, depending on whether at least 95% of the dose is administered to the target volume with the "nTMS-adapted" plan or not. Every patient then receives SRS. | Device | MENTOR |
Primary outcome
Within-patient difference in maximum dose
Time frame: 5 to 2 days before SRS
Within-patient difference in maximum dose (defined as the dose received by the most exposed 0.03 cc of the tissue) to functional M1 between the standard and nTMS-adapted SRS plans, provided that both plans achieve PTV coverage ≥95% and comply with standard organ-at-risk constraints
9 secondary outcomes
Feasibility of plan selection
Time frame: 5 to 2 days before SRS
Target coverage (%) of both plans
Time frame: 5 to 2 days before SRS
Motor outcome
Time frame: At 3, 6 and 12 month follow-up
Motor outcome
Time frame: At 3, 6 and 12 month follow-up
Motor outcome
Time frame: At 3, 6 and 12 month follow-up
Motor outcome
Time frame: At 3, 6 and 12 month follow-up
tumor recurrence
Time frame: At 3, 6 and 12 month follow-up
Quality of life (EQ-5D-5L)
Time frame: At 3, 6, and 12 month follow-up
Presence of Radiation necrosis
Time frame: At 12 month follow-up
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 4 Aug 2026.
- Background: PubMed 32921513Milano MT, Grimm J, Niemierko A, Soltys SG, Moiseenko V, Redmond KJ, Yorke E, Sahgal A, Xue J, Mahadevan A, Muacevic A, Marks LB, Kleinberg LR. Single- and Multifraction Stereotactic Radiosurgery Dose/Volume Tolerances of the Brain. Int J Radiat Oncol Biol Phys. 2021 May 1;110(1):68-86. doi: 10.1016/j.ijrobp.2020.08.013. Epub 2020 Sep 11.
- Background: PubMed 10487566Kondziolka D, Patel A, Lunsford LD, Kassam A, Flickinger JC. Stereotactic radiosurgery plus whole brain radiotherapy versus radiotherapy alone for patients with multiple brain metastases. Int J Radiat Oncol Biol Phys. 1999 Sep 1;45(2):427-34. doi: 10.1016/s0360-3016(99)00198-4.
- Background: PubMed 26065612Lin NU, Lee EQ, Aoyama H, Barani IJ, Barboriak DP, Baumert BG, Bendszus M, Brown PD, Camidge DR, Chang SM, Dancey J, de Vries EG, Gaspar LE, Harris GJ, Hodi FS, Kalkanis SN, Linskey ME, Macdonald DR, Margolin K, Mehta MP, Schiff D, Soffietti R, Suh JH, van den Bent MJ, Vogelbaum MA, Wen PY; Response Assessment in Neuro-Oncology (RANO) group. Response assessment criteria for brain metastases: proposal from the RANO group. Lancet Oncol. 2015 Jun;16(6):e270-8. doi: 10.1016/S1470-2045(15)70057-4. Epub 2015 May 27.
- Background: PubMed 19833552Rossi S, Hallett M, Rossini PM, Pascual-Leone A; Safety of TMS Consensus Group. Safety, ethical considerations, and application guidelines for the use of transcranial magnetic stimulation in clinical practice and research. Clin Neurophysiol. 2009 Dec;120(12):2008-2039. doi: 10.1016/j.clinph.2009.08.016. Epub 2009 Oct 14.
- Background: PubMed 30333959Schwendner MJ, Sollmann N, Diehl CD, Oechsner M, Meyer B, Krieg SM, Combs SE. The Role of Navigated Transcranial Magnetic Stimulation Motor Mapping in Adjuvant Radiotherapy Planning in Patients With Supratentorial Brain Metastases. Front Oncol. 2018 Oct 2;8:424. doi: 10.3389/fonc.2018.00424. eCollection 2018.
- Background: PubMed 8050345Strnad V, Sauer R. [Prostatic carcinoma]. Dtsch Med Wochenschr. 1994 Jul 29;119(30):1054-6. No abstract available. German.
- Background: PubMed 15871509Kamada K, Todo T, Masutani Y, Aoki S, Ino K, Takano T, Kirino T, Kawahara N, Morita A. Combined use of tractography-integrated functional neuronavigation and direct fiber stimulation. J Neurosurg. 2005 Apr;102(4):664-72. doi: 10.3171/jns.2005.102.4.0664.
- Background: PubMed 25701297Scoccianti S, Detti B, Gadda D, Greto D, Furfaro I, Meacci F, Simontacchi G, Di Brina L, Bonomo P, Giacomelli I, Meattini I, Mangoni M, Cappelli S, Cassani S, Talamonti C, Bordi L, Livi L. Organs at risk in the brain and their dose-constraints in adults and in children: a radiation oncologist's guide for delineation in everyday practice. Radiother Oncol. 2015 Feb;114(2):230-8. doi: 10.1016/j.radonc.2015.01.016. Epub 2015 Feb 17.
- Background: PubMed 22234506Hodapp N. [The ICRU Report 83: prescribing, recording and reporting photon-beam intensity-modulated radiation therapy (IMRT)]. Strahlenther Onkol. 2012 Jan;188(1):97-9. doi: 10.1007/s00066-011-0015-x. No abstract available. German.
- Background: PubMed 30981901Seidel K, Hani L, Lutz K, Zbinden C, Redmann A, Consuegra A, Raabe A, Schucht P. Postoperative navigated transcranial magnetic stimulation to predict motor recovery after surgery of tumors in motor eloquent areas. Clin Neurophysiol. 2019 Jun;130(6):952-959. doi: 10.1016/j.clinph.2019.03.015. Epub 2019 Apr 5.
- Related InfoLink provided by the sponsor.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
University Hostpital Bern, Department of Neurosurgery Bern
Bern, Switzerland
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Navigated Transcranial Magnetic Stimulation (nTMS) in people with Metastases to Brain, run by Insel Gruppe AG, University Hospital Bern at 1 site in Switzerland.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 5 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: looking for participants now, as of the sponsor's last update on 4 Aug 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Switzerland. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Each site lists its own contact: choose the nearest one under Trial locations. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Within-patient difference in maximum dose (time frame: 5 to 2 days before SRS). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT07415668, which also lists 10 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 4 Aug 2026.