Localizing hand motor area using resting-state fMRI: validated with direct cortical stimulation

• Published in: Acta neurochirurgica Vol. 156; no. 12; pp. 2295 - 2302
• Main Authors: Qiu, Tian-ming, Yan, Chao-gan, Tang, Wei-jun, Wu, Jin-song, Zhuang, Dong-xiao, Yao, Cheng-jun, Lu, Jun-feng, Zhu, Feng-ping, Mao, Ying, Zhou, Liang-fu
• Format: Journal Article
• Language: English
• Published: Vienna Springer Vienna 01.12.2014; Springer Nature B.V
• Subjects: Adult; Brain Mapping - methods; Brain Neoplasms - diagnosis; Clinical Article - Neurosurgical Techniques; Deep Brain Stimulation; Female; Glioma - diagnosis; Hand - innervation; Humans; Interventional Radiology; Magnetic Resonance Imaging - methods; Male; Medicine; Medicine & Public Health; Middle Aged; Minimally Invasive Surgery; Motor Cortex - physiopathology; Neurology; Neuroradiology; Neurosurgery; Sensitivity and Specificity; Surgical Orthopedics; Resting-state fMRI; Effectiveness; Direct cortical stimulation; Hand motor area; Task-based BOLD fMRI
• ISSN: 0001-6268; 0942-0940; 0942-0940
• DOI: 10.1007/s00701-014-2236-0

Background Resting-state functional magnetic resonance imaging (R-fMRI) is a promising tool in clinical application, especially in presurgical mapping for neurosurgery. This study aimed to investigate the sensitivity and specificity of R-fMRI in the localization of hand motor area in patients with brain tumors validated by direct cortical stimulation (DCS). We also compared this technique to task-based blood oxygenation level-dependent (BOLD) fMRI (T-fMRI). Methods R-fMRI and T-fMRI were acquired from 17 patients with brain tumors. The cortex sites of the hand motor area were recorded by DCS. Site-by-site comparisons between R-fMRI/T-fMRI and DCS were performed to calculate R-fMRI and T-fMRI sensitivity and specificity using DCS as a “gold standard”. R-fMRI and T-fMRI performances were compared statistically Results A total of 609 cortex sites were tested with DCS and compared with R-fMRI findings in 17 patients. For hand motor area localization, R-fMRI sensitivity and specificity were 90.91 and 89.41 %, respectively. Given that two subjects could not comply with T-fMRI, 520 DCS sites were compared with T-fMRI findings in 15 patients. The sensitivity and specificity of T-fMRI were 78.57 and 84.76 %, respectively. In the 15 patients who successfully underwent both R-fMRI and T-fMRI, there was no statistical difference in sensitivity or specificity between the two methods ( p  = 0.3198 and p  = 0.1431, respectively) Conclusions R-fMRI sensitivity and specificity are high for localizing hand motor area and even equivalent or slightly higher compared with T-fMRI. Given its convenience for patients, R-fMRI is a promising substitute for T-fMRI for presurgical mapping