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Functional Near Infrared Spectroscopy of the Sensory and Motor Brain Regions with Simultaneous Kinematic and EMG Monitoring During Motor Tasks
Published on: December 5, 2014
Passive range of motion functional magnetic resonance imaging localizing sensorimotor cortex in sedated children
Robert J Ogg1, Fred H Laningham, Dave Clarke
1Department of Radiological Sciences, St. Jude Children's Research Hospital, Memphis, Tennessee 38104, USA.
Insights
Passive range of motion (ROM) functional MRI (fMRI) accurately maps sensorimotor cortex in sedated children. This technique aids presurgical evaluation for patients unable to cooperate with active tasks.
Area of Science:
- Pediatric Neurology
- Neuroradiology
- Neuroimaging
Background:
- Presurgical evaluation of sensorimotor cortex is crucial for pediatric neurosurgery.
- Functional magnetic resonance imaging (fMRI) is a key tool for mapping brain function.
- Sedation can be necessary for pediatric imaging, but may limit active task performance.
Purpose of the Study:
- To evaluate the efficacy of passive range of motion (ROM) under conscious sedation for localizing sensorimotor cortex using fMRI in children.
- To determine if passive ROM fMRI can serve as a reliable presurgical mapping tool.
Main Methods:
- Retrospective analysis of fMRI data from 16 children undergoing presurgical evaluation.
- Passive ROM of hand, foot, and face performed during blood oxygen level-dependent fMRI sequences.
- Comparison with intraoperative electrocorticography (ECoG) in select cases.
Main Results:
- Passive ROM fMRI successfully localized functional hand, leg, and face regions in sedated children.
- Results from passive ROM fMRI were consistent with intraoperative ECoG findings.
- Thirteen of 16 children underwent successful resection based on passive ROM fMRI localization without new deficits.
Conclusions:
- Passive ROM fMRI is a viable and accurate method for mapping sensorimotor cortex in sedated pediatric patients.
- This technique expands functional mapping capabilities to non-cooperative or unwilling pediatric patients.
- Passive ROM fMRI offers a valuable alternative for presurgical planning in pediatric neurosurgery.
Object:
In this study, the authors examined whether passive range of motion (ROM) under conscious sedation could be used to localize sensorimotor cortex using functional MR (fMR) imaging in children as part of their presurgical evaluation.
Methods:
After obtaining institutional review board approval (for retrospective analysis of imaging data acquired for clinical purposes) and informed consent, 16 children underwent fMR imaging. All 16 had lesions; masses were found in 9 patients and cortical dysplasia was found in 4; the lesions in 3 patients were not diagnosed. Passive ROM was performed during blood oxygen level-dependent MR imaging sequences. Three of the patients also performed active motor tasks during the fMR imaging study. All patients were evaluated using passive ROM of the hand and/or foot; 3 patients were evaluated for passive touch of the face. In 9 cases, intraoperative electrocorticography (ECoG) was used. Five of the patients underwent intraoperative ECoG to evaluate for seizure activity. Four patients had intraoperative ECoG for motor mapping. Five of the patients had subdural grids placed for extraoperative monitoring.
Results:
In 3 cases, the active and passive ROMs colocalized. In 4 patients ECoG was used to identify motor cortex, and in all 4 motor ECoG yielded results consistent with the passive ROM localization. Thirteen of 16 children have undergone resection based on passive ROM fMR imaging findings with no unanticipated deficits.
Conclusions:
These preliminary data suggest that passive ROM fMR imaging can accurately detect functional hand, leg, and face regions of the sensorimotor cortex in the sedated child. This extends current extraoperative mapping capabilities to patients unable or unwilling to cooperate for active motor tasks.
