Impact of Navigated Task-specific fMRI on Direct Cortical Stimulation

Area of Science:

• Neurosurgery
• Neuroimaging
• Cognitive Neuroscience

Background:

• Cortical mapping (CM) using direct cortical stimulation (DCS) is crucial for preserving language function during awake craniotomy.
• Patient cooperation in DCS can be compromised by neurological symptoms and discomfort.

Purpose of the Study:

• To assess the impact of navigated task-specific functional MRI (nfMRI) on the practical application of DCS during awake craniotomy.
• To compare the multimodal approach (mCM) combining nfMRI and DCS with electrical CM (eCM) using DCS alone.

Main Methods:

• Glioma patients underwent fMRI-based CM for motor and language tasks prior to awake craniotomy.
• Patients were randomized to mCM or eCM groups for intraoperative language mapping.
• Methodological aspects (DCS duration, stimuli, seizures) and nfMRI-DCS correspondence were analyzed.

Main Results:

• Navigated fMRI did not significantly alter DCS practical aspects between the mCM and eCM groups.
• Patients with lower presurgical language performance exhibited reduced DCS duration.
• High correspondence was observed between DCS and nfMRI for motor and language areas.

Conclusions:

• Navigated fMRI data integration did not practically influence DCS procedures in awake surgery.
• Presurgical language impairments significantly restrict the utility of DCS mapping in awake craniotomy.