Localization of the cortical motor area by functional magnetic resonance imaging with gradient echo and echo-planar...

Functional magnetic resonance imaging (MRI) with gradient echo and echo-planar sequences was applied to healthy volunteers and neurological patients to evaluate the feasibility of detecting and localizing the motor cortex. Time course of the change in signal intensity by an alternate repetition of motor task (squeezing hand) and rest periods was also examined. The motor cortex was localized as the area of signal increase in 88.9% of 45 healthy volunteers by gradient echo method, which mainly reflected the cortical vein, and 83.3% of 30 healthy volunteers by echo-planar method, which mainly reflected the cerebral gyrus. Among 21 volunteers who participated in the both studies, success rate in the localization for the motor cortex was 90.5% (21 volunteers) by gradient echo method and 81% (17 volunteers) by echo-planar method. It was also shown from the time course of the change in signal intensity that signal increase in the most significantly activated area generally corresponded with the periods of the motor task, and the latency between the onset of signal increase and the onset of motor task was usually about 4 seconds. In four of 6 patients with brain tumor, the motor cortex was localized, although activated areas were displaced or distorted. The results indicate that fMRI, either with gradient echo or echo-planar sequence, is a useful method for localizing the primary motor area activated during the motor task and clinically available for noninvasive evaluation of the anatomical relation between brain tumors and the motor area before surgical therapy.