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Published on: August 12, 2019
Concordance between functional magnetic resonance imaging and intraoperative language mapping
1Department of Neurology, Memorial Sloan-Kettering Cancer Center, Weill Medical College of Cornell University, New York, NY, USA. william.orrison@hsc.utah.edu
Stereotactic and Functional Neurosurgery
|June 15, 2000
Summary
Functional MRI (fMRI) reliably identifies language areas, matching intraoperative electrophysiology findings. This confirms fMRI
Area of Science:
- Neuroimaging and Electrophysiology
- Cognitive Neuroscience
- Neurosurgery
Background:
- Established correlation between functional-magnetic resonance imaging (fMRI) and intraoperative electrophysiology for sensorimotor cortex localization.
- Limited established concordance between fMRI and intraoperative methods for language-sensitive cortex mapping.
- Need for validation of fMRI's utility in preoperative language area identification.
Observation:
- Study involved 21 patients undergoing fMRI and intraoperative electrophysiology (somatosensory evoked potential recordings, direct cortical stimulation).
- Language and sensorimotor mapping were performed using both fMRI and electrophysiological techniques.
- Direct cortical stimulation targeted Broca's and Wernicke's areas in 5 patients.
Findings:
- Complete concordance was observed between fMRI and intraoperative electrophysiology in localizing functional areas when both methods yielded responses.
- fMRI accurately mapped sensorimotor cortex in 21 patients and language-sensitive cortex in 5 patients.
- No discrepancies were reported between fMRI and electrophysiological localization.
Implications:
- Functional MRI (fMRI) demonstrates high reliability as a preoperative tool for identifying critical language-sensitive brain regions.
- These findings support the integration of fMRI into surgical planning for procedures involving eloquent cortex.
- Enhanced preoperative mapping can improve patient outcomes by minimizing risks of neurological deficits.
