Role of the mode of sensory stimulation in presurgical brain mapping in which functional magnetic resonance imaging is used

2000 ◽  
Vol 93 (3) ◽  
pp. 427-431 ◽  
Author(s):  
Elisabeth Le Rumeur ◽  
Michèle Allard ◽  
Eric Poiseau ◽  
Pierre Jannin

Object. The aim of this study was to evaluate different types of sensory stimulation used to distinguish between microvasculature and venous drainage on functional magnetic resonance (fMR) images with blood oxygen level—dependent (BOLD) contrast.Methods. Seven volunteers received three sensory stimulations. One consisted of small discontinuous automated pokes to the ventral aspect of the right thumbtip. The other two were delivered by the investigator, who vigorously brushed the ventral aspect of the right thumbtip either alone or in combination with the thenar region. Seven contiguous axial slices of the head were acquired using echoplanar fMR imaging during each mode of stimulation. Box-car analysis and Student's t-test were performed. Cluster analysis was used to determine significant differences between rest and activation phases.The major findings were 1) that a discontinuous sensory stimulation involving a small skin area was able to evoke a limited activated area in the postcentral gyrus with a low activation index (AI [2%]); 2) that this limited activated area was included in the activated area elicited by the continuous sensory stimulations; and 3) that this also evoked multiple activated areas exhibiting AIs of either approximately 2% or greater than 5%. This indicated that the limited discontinuous tactile stimulation evoked a BOLD-contrast fMR image essentially of microvasculature, whereas the more extensive continuous stimulations evoked a BOLD-contrast fMR image in both microvasculature and venous drainage.Conclusions. Different sensory stimulations are necessary to differentiate primary sensory cortex from venous drainage for presurgical brain mapping.

2000 ◽  
Vol 92 (1) ◽  
pp. 45-51 ◽  
Author(s):  
Richard G. Bittar ◽  
Alain Ptito ◽  
David C. Reutens

Object. Removal or disconnection of an entire cerebral hemisphere is occasionally used to treat refractory seizures. Patients who have undergone a hemispherectomy provide useful models to study the reorganization of cortical somatosensory representation. This plasticity may be a consequence of the pathological lesion, the hemispherectomy itself, or both.Methods. Three patients who had undergone hemispherectomy were studied with functional magnetic resonance (fMR) imaging. Responses to sensory stimulation in normal hands and hands opposite the lesioned hemisphere were studied. Multislice T2*-weighted gradient-echo echoplanar images were obtained using a 1.5-tesla MR imager. The activation condition consisted of somatosensory stimulation of the index finger. A T1-weighted anatomical MR image was acquired. The fMR and anatomical MR images were coregistered, and statistically significant activation foci (p < 0.01) were identified. Stimulation of the normal hand produced activation in the primary somatosensory cortex (SI) in all patients. Stimulation of the impaired hand resulted in activation of the ipsilateral parietal operculum (second somatosensory area [SII]) and posterior parietal lobe (Brodmann's Area 7) in all cases, but no activation was elicited in the SI in any patient. In addition, other areas within the ipsilateral frontal and parietal lobes were activated in some individuals.Conclusions. Residual somatosensory function in the hand opposite the lesioned hemisphere is mediated by the SII and other cortical regions in the intact hemisphere, without involvement of the SI.


2004 ◽  
Vol 101 (2) ◽  
pp. 310-313 ◽  
Author(s):  
Tsutomu Nakada ◽  
Yukihiko Fujii ◽  
Ingrid L. Kwee

Object. The authors investigated brain strategies associated with hand use in an attempt to clarify genetic and nongenetic factors influencing handedness by using high-field functional magnetic resonance imaging. Methods. Three groups of patients were studied. The first two groups comprised individuals in whom handedness developed spontaneously (right-handed and left-handed groups). The third group comprised individuals who were coercively trained to use the right hand and developed mixed handedness, referred to here as trained ambidexterity. All trained ambidextrous volunteers were certain that they were innately left-handed, but due to social pressure had modified their preferred hand use for certain tasks common to the right hand. Although right-handed and left-handed volunteers displayed virtually identical cortical activation, involving homologous cortex primarily located contralateral to the hand motion, trained ambidextrous volunteers exhibited a clearly unique activation pattern. During right-handed motion, motor areas in both hemispheres were activated in these volunteers. During left-handed motion, the right supplemental motor area and the right intermediate zone of the anterior cerebellar lobe were activated significantly more frequently than observed in naturally right-handed or left-handed volunteers. Conclusions. The results provide strong evidence that cortical organization of spontaneously developed right- and left-handedness involves homologous cortex primarily located contralateral to the hand motion, and this organization is likely to be prenatally determined. By contrast, coerced training of the nondominant hand during the early stages of an individual's development results in mixed handedness (trained ambidexterity), indicating cortical reorganization.


2000 ◽  
Vol 93 (2) ◽  
pp. 214-223 ◽  
Author(s):  
Derek L. G. Hill ◽  
Andrew D. Castellano Smith ◽  
Andrew Simmons ◽  
Calvin R. Maurer ◽  
Timothy C. S. Cox ◽  
...  

Object. Several authors have recently reported studies in which they aim to validate functional magnetic resonance (fMR) imaging against the accepted gold standard of invasive electrophysiological monitoring. The authors have conducted a similar study, and in this paper they identify and quantify two characteristics of these data that can make such a comparison problematic.Methods. Eight patients in whom surgery for epilepsy was performed and five healthy volunteers underwent fMR imaging to localize the part of the sensorimotor cortex responsible for hand movement. In the patient group subdural electrode mats were subsequently implanted to identify eloquent regions of the brain and the epileptogenic zone. The fMR imaging data were processed to correct for motion during the study and then registered with a postimplantation computerized tomography (CT) scan on which the electrodes were visible. The motion during imaging in the two groups studied, and the deformation of the brain between the preoperative images and postoperative scans were measured.The patients who underwent epilepsy surgery moved significantly more during fMR imaging experiments than healthy volunteers performing the same motor task. This motion had a particularly increased out-of-plane component and was significantly more correlated with the stimulus than in the volunteers. This motion was especially increased when the patients were performing a task on the side affected by the lesion. The additional motion is hard to correct and substantially degrades the quality of the resulting fMR images, making it a much less reliable technique for use in these patients than in others. Also, the authors found that after electrode implantation, the brain surface can shift more than 10 mm relative to the skull compared with its preoperative location, substantially degrading the accuracy of the comparison of electrophysiological measurements made in the deformed brain and fMR studies obtained preoperatively.Conclusions. These two findings indicate that studies of this sort are currently of limited use for validating fMR imaging and should be interpreted with care. Additional image analysis research is necessary to solve the problems caused by patients' motion and brain deformation.


1998 ◽  
Vol 88 (5) ◽  
pp. 863-869 ◽  
Author(s):  
Jesús Pujol ◽  
Gerardo Conesa ◽  
Joan Deus ◽  
Luis López-Obarrio ◽  
Fabián Isamat ◽  
...  

Object. The authors sought to evaluate the advantages and limitations of functional magnetic resonance (fMR) imaging when it was used regularly in the clinical context to identify the central sulcus. Methods. A 1.5-tesla MR system comprising a spoiled gradient recalled acquisition in the steady-state functional sequence and a cross-hand cancellation analysis method were used to evaluate 50 surgical candidates with centrally located space-occupying lesions in the brain. Three-dimensional (3-D) models of the patient's head and brain showing the relative position of the tumor and the eloquent cortex were obtained in each case. A selective and reproducible focal activation was found, indicating the probable central sulcus position in 41 patients (82%). Direct cortical stimulation confirmed the fMR findings in 100% of 22 intraoperatively assessed patients. Failure to identify the central sulcus occurred in 18% of cases and was mainly a consequence of intrinsic damage in the primary sensorimotor region that resulted in severe hand paresis. Conclusions. Although specific factors were identified that contributed to reduced sensitivity of fMR imaging in the clinical context, the present study supports functional assessment and 3-D representation of specific surgical situations as generally feasible in common practice.


2005 ◽  
Vol 103 (2) ◽  
pp. 267-274 ◽  
Author(s):  
Nicole Petrovich ◽  
Andrei I. Holodny ◽  
Viviane Tabar ◽  
Denise D. Correa ◽  
Joy Hirsch ◽  
...  

Object. The goal of this study was to investigate discordance between the location of speech arrest during awake cortical mapping, a common intraoperative indicator of hemispheric dominance, and silent speech functional magnetic resonance (fMR) imaging maps of frontal language function. Methods. Twenty-one cases were reviewed retrospectively. Images of silent speech fMR imaging activation were coregistered to anatomical MR images obtained for neuronavigation. These were compared with the intraoperative cortical photographs and the behavioral results of electrocorticography during awake craniotomy. An fMR imaging control study of three healthy volunteers was then conducted to characterize the differences between silent and vocalized speech fMR imaging protocols used for neurosurgical planning. Conclusions. Results of fMR imaging showed consistent and predominant activation of the inferior frontal gyrus (IFG) during silent speech tasks. During intraoperative mapping, however, 16 patients arrested in the precentral gyrus (PRG), well posterior to the fMR imaging activity. Of those 16, 14 arrested only in the PRG and not in the IFG as silent speech fMR imaging predicted. The control fMR imaging study showed that vocalized speech fMR imaging shifts the location of the fMR imaging prediction to include the motor strip and may be more appropriate for neurosurgical planning.


2001 ◽  
Vol 95 (5) ◽  
pp. 804-815 ◽  
Author(s):  
Elie Lobel ◽  
Philippe Kahane ◽  
Ute Leonards ◽  
Marie-Hélène Grosbras ◽  
Stéphane Lehéricy ◽  
...  

Object. The goal of this study was to investigate the anatomical localization and functional role of human frontal eye fields (FEFs) by comparing findings from two independently conducted studies. Methods. In the first study, 3-tesla functional magnetic resonance (fMR) imaging was performed in 14 healthy volunteers divided into two groups: the first group executed self-paced voluntary saccades in complete darkness and the second group repeated newly learned or familiar sequences of saccades. In the second study, intracerebral electrical stimulation (IES) was performed in 38 patients with epilepsy prior to surgery, and frontal regions where stimulation induced versive eye movements were identified. These studies showed that two distinct oculomotor areas (OMAs) could be individualized in the region classically corresponding to the FEFs. One OMA was consistently located at the intersection of the superior frontal sulcus with the fundus of the superior portion of the precentral sulcus, and was the OMA in which saccadic eye movements could be the most easily elicited by electrical stimulation. The second OMA was located more laterally, close to the surface of the precentral gyrus. The fMR imaging study and the IES study demonstrated anatomical and stereotactic agreement in the identification of these cortical areas. Conclusions. These findings indicate that infracentimetric localization of cortical areas can be achieved by measuring the vascular signal with the aid of 3-tesla fMR imaging and that neuroimaging and electrophysiological recording can be used together to obtain a better understanding of the human cortical functional anatomy.


2005 ◽  
Vol 102 (1) ◽  
pp. 169-173 ◽  
Author(s):  
Kuan H. Kho ◽  
Frans S. S. Leijten ◽  
Geert-Jan Rutten ◽  
Jan Vermeulen ◽  
Peter van Rijen ◽  
...  

✓ The Wada test is still considered the gold standard for determining the language-dominant hemisphere prior to brain surgery. The authors report on a 34-year-old right-handed woman whose Wada test results indicated that the right hemisphere was dominant for language. In contrast, functional magnetic resonance (fMR) imaging was indicative of bilaterally represented language functions. Activation in the left hemisphere demonstrated on fMR imaging was most pronounced in the Broca area. Importantly, fMR imaging results in this area were confirmed on electrocortical stimulation mapping. These contradictory findings indicated that a right hemispherre dominance for language according to the Wada test should be questioned and verified using electrocortical stimulation. Nonetheless, the question remains whether involvement of these areas in the left frontal hemisphere is critical for language, as these were spared during surgery.


2000 ◽  
Vol 93 (5) ◽  
pp. 774-783 ◽  
Author(s):  
Maxwell Boakye ◽  
Sean C. Huckins ◽  
Nikolaus M. Szeverenyi ◽  
Bobby I. Taskey ◽  
Charles J. Hodge

Object. Functional magnetic resonance (fMR) imaging was used to determine patterns of cerebral blood flow changes in the somatosensory cortex that result from median nerve stimulation (MNS).Methods. Ten healthy volunteers underwent stimulation of the right median nerve at frequencies of 5.1 Hz (five volunteers) and 50 Hz (five volunteers). The left median nerve was stimulated at frequencies of 5.1 Hz (two volunteers) and 50 Hz (five volunteers). Tactile stimulation (with a soft brush) of the right index finger was also applied (three volunteers). Functional MR imaging data were transformed into Talairach space coordinates and averaged by group. Results showed significant activation (p < 0.001) in the following regions: primary sensorimotor cortex (SMI), secondary somatosensory cortex (SII), parietal operculum, insula, frontal cortex, supplementary motor area, and posterior parietal cortices (Brodmann's Areas 7 and 40). Further analysis revealed no statistically significant difference (p > 0.05) between volumes of cortical activation in the SMI or SII resulting from electrical stimuli at 5.1 Hz and 50 Hz. There existed no significant differences (p > 0.05) in cortical activity in either the SMI or SII resulting from either left- or right-sided MNS. With the exception of the frontal cortex, areas of cortical activity in response to tactile stimulation were anatomically identical to those regions activated by electrical stimulation. In the SMI and SII, activation resulting from tactile stimulation was not significantly different (p > 0.05) from that resulting from electrical stimulation.Conclusions. Electrical stimulation of the median nerve is a reproducible and effective means of activating multiple somatosensory cortical areas, and fMR imaging can be used to investigate the complex network that exists between these areas.


1995 ◽  
Vol 83 (2) ◽  
pp. 262-270 ◽  
Author(s):  
Aina Puce ◽  
R. Todd Constable ◽  
Marie L. Luby ◽  
Gregory McCarthy ◽  
Anna C. Nobre ◽  
...  

✓ 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.


1998 ◽  
Vol 89 (5) ◽  
pp. 769-779 ◽  
Author(s):  
Charles J. Hodge ◽  
Sean C. Huckins ◽  
Nikolaus M. Szeverenyi ◽  
Michael M. Fonte ◽  
Jacob G. Dubroff ◽  
...  

Object. Functional magnetic resonance (fMR) imaging was performed in human volunteers to determine the lateral perisylvian cortical areas activated by innocuous cutaneous stimulation. Methods. Eight volunteers who underwent 53 separate experiments form the basis of this report. Eight contiguous coronal slices were obtained using echoplanar fMR imaging techniques while participants were at rest and while somatosensory activation stimuli consisting of vibration or air puffs were delivered to various body areas. The data were analyzed using Student's t-test and cluster analysis to determine significant differences between the resting and activated states. The findings were as follows: the areas in the lateral cortex activated by the sitmuli were the primary sensory cortex (SI), the second somatosensory area (SII), the insula, the superior parietal lobule, and the retroinsular parietal operculum (RIPO). Somatotopy was demonstrable in SI but not in the other areas identified. There was a surprisingly low correlation between the amount of cortex activated in the various areas, which could mean separate inputs and functions for the areas identified. The highest correlation was found between activity in SII and RIPO (0.69). Conclusions. The authors maintain that fMR imaging can be used to identify multiple lateral somatosensory areas in humans. Somatotopy is demonstrated in SI but not in the other lateral cortical sensory areas. The correlations between the amounts of cortex activated in the different lateral sensory areas are low. Recognition of the multiple lateral sensory areas is important both for understanding sensory cortical function and for safe interpretation of studies designed to identify the central sulcus by activating SI.


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