Functional MR imaging of visual and motor cortex stimulation at high temporal resolution using a flash technique on a standard 1.5 tesla scanner

Neuropathic facial pain can be a debilitating condition characterized by stabbing, burning, dysesthetic sensation. With a large range of causes and types, including deafferentation, postherpetic, atypical, and idiopathic, both medicine and neurosurgery have struggled to find effective treatments that address this broad spectrum of facial pain. The authors report the use of motor cortex stimulation to alleviate 3 distinct conditions associated with intractable facial pain: trigeminal deafferentation pain following rhizotomy, deafferentation pain secondary to meningioma, and postherpetic neuralgia. Functional MR imaging was used to localize facial areas on the precentral gyrus prior to surgery. All 3 patients experienced long-lasting complete or near-complete resolution of pain following electrode implantation. Efficacy in pain reduction was achieved through variation of stimulation settings over the course of treatment, and it was assessed using the visual analog scale and narrative report. Surgical complications included moderate postsurgical incisional pain, transient cerebral edema, and intraoperative seizure. The authors' results affirm the efficacy and broaden the application of motor cortex stimulation to several forms of intractable facial pain.

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Epidural motor cortex stimulation with functional imaging guidance

Neurosurgical FOCUS ◽

10.3171/foc.2001.11.3.5 ◽

2001 ◽

Vol 11 (3) ◽

pp. 1-4 ◽

Cited By ~ 24

Author(s):

Alon Y. Mogilner ◽

Ali R. Rezai

Keyword(s):

Motor Cortex ◽

Mr Imaging ◽

Functional Imaging ◽

Surgical Planning ◽

Functional Brain Imaging ◽

Anatomical Landmarks ◽

Motor Cortex Stimulation ◽

Imaging Data ◽

Direct Stimulation ◽

Imaging Guidance

Chronic epidural motor cortex stimulation (MCS) has been shown to have promise in the treatment of patients with refractory deafferentation pain. Precise placement of the electrode over the motor cortex region corresponding to the area of pain is essential for the success of this procedure. Whereas standard anatomical landmarks have been used in the past in conjunction with image guidance, the use of functional brain imaging can be beneficial in the precise surgical planning. The authors report the use of functional imaging–guided frameless stereotactic surgery for epidural MCS. Five patients underwent MCS in which functional imaging guidance was used. Prior to surgery, patients underwent magnetic resonance (MR) imaging with skin fiducial markers placed on standard anatomical reference prints, followed by magnetoencephalography (MEG) mapping of the sensory and motor cortices. In two patients, functional MR imaging was also performed using a motor task paradigm. The functional imaging data were integrated into a frameless stereotactic database by using a three-dimensional coregistration algorithm. Subsequently, a frameless stereotactic craniotomy was performed using the integrated anatomical and functional imaging data for surgical planning. Intraoperative somatosensory evoked potentials (SSEPs) and direct stimulation were used to confirm the target and final placement of the electrode. Direct stimulation and SSEPs performed intraoperatively confirmed the accuracy of the functional imaging data. Trial periods of stimulation successfully reduced pain in three of the five patients who then underwent permanent internal placement of the system. At a mean 6-month follow up, these patients reported an average reduction in pain of 55% on a visual analog scale. The integration of functional and anatomical imaging data allows for precise and efficient surgical planning and may reduce the time necessary for intraoperative physiological verification.

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Delayed feedback of somato-motor cortex activations modulates finger tapping results in real-time functional MR imaging

Clinical Neurophysiology ◽

10.1016/j.clinph.2006.11.084 ◽

2007 ◽

Vol 118 (4) ◽

pp. e33

Author(s):

J. Gawehn ◽

G. Vucurevic ◽

P. Dellani ◽

P. Urban ◽

P. Stoeter

Keyword(s):

Motor Cortex ◽

Mr Imaging ◽

Real Time ◽

Delayed Feedback ◽

Finger Tapping ◽

Functional Mr Imaging

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Early diastolic function observed in canine model of reperfused transmural myocardial infarction using high temporal resolution MR imaging

Journal of Cardiovascular Magnetic Resonance ◽

10.1186/1532-429x-14-s1-w65 ◽

2012 ◽

Vol 14 (S1) ◽

Cited By ~ 1

Author(s):

Ziheng Zhang ◽

Donald Dione ◽

Ben A Lin ◽

James S Duncan ◽

Albert J Sinusas ◽

...

Keyword(s):

Myocardial Infarction ◽

Mr Imaging ◽

Diastolic Function ◽

Temporal Resolution ◽

Canine Model ◽

High Temporal Resolution

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Functional magnetic resonance imaging of sensory and motor cortex: comparison with electrophysiological localization

Journal of Neurosurgery ◽

10.3171/jns.1995.83.2.0262 ◽

1995 ◽

Vol 83 (2) ◽

pp. 262-270 ◽

Cited By ~ 228

Author(s):

Aina Puce ◽

R. Todd Constable ◽

Marie L. Luby ◽

Gregory McCarthy ◽

Anna C. Nobre ◽

...

Keyword(s):

Electrical Stimulation ◽

Magnetic Resonance ◽

Motor Cortex ◽

Mr Imaging ◽

Sensorimotor Cortex ◽

Functional Magnetic Resonance ◽

Planar Imaging ◽

Content Type ◽

Functional Mr Imaging ◽

Fine Print

✓ Functional magnetic resonance (MR) imaging was performed using a 1.5-tesla MR system to localize sensorimotor cortex. Six neurologically normal subjects were studied by means of axial gradient-echo images with a motor task and one or more sensory tasks: 1) electrical stimulation of the median nerve; 2) continuous brushing over the thenar region; and 3) pulsed flow of compressed air over the palm and digits. An increased MR signal was observed in or near the central sulcus, consistent with the location of primary sensory and motor cortex. Four patients were studied using echo planar imaging sequences and motor and sensory tasks. Three patients had focal refractory seizures secondary to a lesion impinging on sensorimotor cortex. Activation seen on functional MR imaging was coextensive with the location of the sensorimotor area determined by evoked potentials and electrical stimulation. Functional MR imaging provides a useful noninvasive method of localization and functional assessment of sensorimotor cortex.

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