Abstract
.Intrinsic signal optical imaging (ISOI) within the first decade of its use in humans showed its capacity as a precise functional mapping tool. It is a powerful tool that can be used intraoperatively to help a surgeon to directly identify functional areas of the cerebral cortex. Its use is limited to the intraoperative setting as it requires a craniotomy and durotomy for direct visualization of the brain. It has been applied in humans to study language, somatosensory and visual cortices, cortical hemodynamics, epileptiform activity, and lesion delineation. Despite studies showing clear evidence of its usefulness in clinical care, its clinical use in humans has not grown. Impediments imposed by imaging in a human operating room setting have hindered such work. However, recent studies have been aimed at overcoming obstacles in clinical studies establishing the benefits of its use to patients. This review provides a description of ISOI and its use in human studies with an emphasis on the challenges that have hindered its widespread use and the recent studies that aim to overcome these hurdles. Clinical studies establishing the benefits of its use to patients would serve as the impetus for continued development and use in humans.
Highlights
Neurosurgical approaches are used to remove brain tumors and to resect tissue in diseases such as epilepsy
This review provides a brief description of intrinsic signal optical imaging (ISOI), discusses the challenges of ISOI in the human operating room (OR), presents intriguing research findings in humans when applied to study language, somatosensory and visual cortices, cortical hemodynamics, epileptiform activity, and lesion delineation, and describes potential future directions for its practical intraoperative approach in the treatment of neurological disease
This study found that in response to somatosensory stimulation, the late positive phase of the optical signal correlated in time and space with the blood oxygenation level-dependent (BOLD) functional magnetic resonance imaging (fMRI) signal, though not precisely
Summary
Neurosurgical approaches are used to remove brain tumors and to resect tissue in diseases such as epilepsy. Common approaches for identifying diseased tissue include MRI scans and, in the case of epilepsy, electrical grid recordings prior to resection. These methods are still relatively crude and leave much room for improvement. This review discusses the use of intrinsic signal optical imaging (ISOI) in the human operating room (OR), its use as a functional brain mapping tool for research, and potential future trends for its practical intraoperative approach in the treatment of neurological disease. This review provides a brief description of ISOI, discusses the challenges of ISOI in the human OR, presents intriguing research findings in humans when applied to study language, somatosensory and visual cortices, cortical hemodynamics, epileptiform activity, and lesion delineation, and describes potential future directions for its practical intraoperative approach in the treatment of neurological disease
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