nTMS in Planning Stereotactic Radiosurgery in Patients With Brain Metastases in the Motor Cortex

This trial studies how well nTMS works in planning for stereotactic radiosurgery in patients with brain metastases in the motor cortex. Stereotactic radiosurgery is a type of radiation therapy that delivers high doses of radiation, which can sometimes lead to damage occurring to the brain and surrounding areas. The motor cortex (the part of the nervous system that controls muscle movement), however, currently has no radiation dose limit. nTMS is a non-invasive tool that uses sensors on a patient's muscle to trace the location in their brain that controls that muscle and is currently used by doctors to decide where to operate so as not to damage the motor nerves. nTMS may effectively help plan radiation treatment using SRS and help doctors decide on how much radiation can be used on motor nerves.

Inclusion Criteria: * Adult patients with brain metastases located in or near the motor cortex who have previously received SRS to that lesion within the prior 3-18 months * Patients must be able to participate in nTMS of bilateral motor cortices * Patients must be able to participate in an electromyography (EMG) * Patient's must have utilized magnetic resonance imaging (MRI) for their previous SRS treatment planning * Patient must be able to complete the Functional and Quality of Life questionnaires in English Exclusion Criteria: * Significant cognitive or psychiatric symptoms that prevent the ability to complete a physical exam, questionnaires, or participate in nTMS or EMG * Poor performance status Karnofsky performance score (KPS \< 60) that prevents the ability to participate in a physical exam, nTMS, or EMG. Patients will not be excluded if they are not able to complete the exploratory EEG analysis * Patients receiving any prior treatment that might impact their cognitive, psychiatric, or motor cortex function