Quantitative comparisons on hand motor functional areas determined by resting state and task BOLD fMRI and anatomical MRI for pre-surgical planning of patients with brain tumors.

Bob L Hou,Jeffrey S Carpenter,Sanjay Bhatia

doi:10.1016/j.nicl.2016.03.003

Bob L Hou, Jeffrey S Carpenter + Show 1 more

Open Access

https://doi.org/10.1016/j.nicl.2016.03.003

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Journal: NeuroImage. Clinical	Publication Date: Jan 1, 2016
Citations: 22	License type: cc-by

Affiliation: West Virginia University Hospitals

Abstract

For pre-surgical planning we present quantitative comparison of the location of the hand motor functional area determined by right hand finger tapping BOLD fMRI, resting state BOLD fMRI, and anatomically using high resolution T1 weighted images. Data were obtained on 10 healthy subjects and 25 patients with left sided brain tumors. Our results show that there are important differences in the locations (i.e., > 20 mm) of the determined hand motor voxels by these three MR imaging methods. This can have significant effect on the pre-surgical planning of these patients depending on the modality used. In 13 of the 25 cases (i.e., 52%) the distances between the task-determined and the rs-fMRI determined hand areas were more than 20 mm; in 13 of 25 cases (i.e., 52%) the distances between the task-determined and anatomically determined hand areas were > 20 mm; and in 16 of 25 cases (i.e., 64%) the distances between the rs-fMRI determined and anatomically determined hand areas were more than 20 mm. In just three cases, the distances determined by all three modalities were within 20 mm of each other. The differences in the location or fingerprint of the hand motor areas, as determined by these three MR methods result from the different underlying mechanisms of these three modalities and possibly the effects of tumors on these modalities.

Highlights

Location of “fingerprints” of the voxels for hand function in the primary sensory-motor cortex is an important part of the pre-operative evaluation of a patient when surgery near this area is being contemplated
Even though the hand functional areas of the motor cortex can often be localized by anatomical landmarks alone (Yousry et al, 1997), functional localization based on anatomy can often be unreliable (Alkhadi et al, 2000; Carpentier et al, 2001; Duffau, 2001; Mesulam, 2000; Rutten and Ramsey, 2010) for a patient with brain disease
Considering the voxel size of the rs-functional MRI (fMRI) and the task fMRI as approximate 3 mm3, we demonstrate in this study that for the majority of the tumor cases the distances of the hand motor functional areas determined from the three MRI methods are longer than 20 (±3) mm and the areas determined from the task fMRI were accurate in the localization of the motor cortex when intra-operative stimulation was performed on selected cases

Summary

Introduction

Location of “fingerprints” of the voxels for hand function in the primary sensory-motor cortex is an important part of the pre-operative evaluation of a patient when surgery near this area is being contemplated. One of fMRI modalities measures changes in the ratio of oxygenated to deoxygenated hemoglobin in capillary beds because of their different magnetic properties This technique called Blood Oxygen Level Dependent (BOLD) fMRI allows mapping of cortical areas based on task activated local field potentials and their coupling with the local vasculature causing changes in the levels of oxygenated hemoglobin due to the changes in the cerebral metabolic rate of oxygen consumption (CMRO2), cerebral blood flow (CBF) and cerebral blood volume (CBV) (Buxton et al, 2004). Because this technique requires patient participation, an optimal task performance may not occur in several groups of patients including young children or the elderly or those with paresis or cognitive deficits, either inherent or as a consequence of medications, drugs or anesthesia

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