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Topographic Mapping of the Primary Sensory Cortex Using Intraoperative Optical Imaging and Tactile Irritation
Witold H Polanski1, Martin Oelschlägel2, Tareq A Juratli3
1Department of Neurosurgery, University Hospital of Dresden, Fiedlerstr. 74, 01307, Dresden, Germany. Witold.polanski@uniklinikum-dresden.de.
Brain Topography
|November 29, 2022
Summary
Intraoperative optical imaging (IOI) with painless tactile stimulation effectively maps the primary sensory cortex (PSC). This novel method aligns with fMRI findings and is suitable for awake brain surgeries.
Area of Science:
- Neurosurgery
- Medical Imaging
- Neuroscience
Background:
- Accurate tumor boundary determination in eloquent brain regions is crucial for maximizing resection extent.
- Intraoperative optical imaging (IOI) combined with median nerve stimulation aids in primary sensory cortex (PSC) visualization.
Purpose of the Study:
- To introduce and assess a novel IOI approach using painless tactile irritation for topographic mapping of the PSC.
- To compare the efficacy of this new IOI method with preoperative functional MRI (fMRI).
Main Methods:
- Five patients with tumors near the PSC underwent tumor removal with IOI and fMRI.
- IOI involved painless tactile irritation of different body parts to map the PSC.
- IOI results were compared with fMRI findings and IOI using median nerve stimulation.
Main Results:
- Tactile irritation of the hand induced reliable cerebral blood volume changes during IOI under anesthesia.
- IOI activation maps from tactile stimulation were comparable to those from median nerve stimulation and fMRI.
- Tactile irritation demonstrated a plausible topographic organization of body regions along the PSC.
Conclusions:
- IOI with painless tactile irritation is a feasible and effective method for topographic mapping of the PSC.
- This technique is suitable for awake surgeries due to its painless nature and congruence with fMRI findings.
- Further standardization is needed for broader neurosurgical application.
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