Rest-fMRI-A Potential Substitute for Task-fMRI?

Objective The aim of this study was to assess the reliability of resting-state functional magnetic resonance imaging (rest-fMRI) in mapping language areas for preoperative planning, versus standard task-based techniques, which are at times difficult to perform in clinical settings. Our study also aimed to evaluate the overlap between language areas identified through rest-fMRI and the standard task-fMRI, in neurosurgical cases. Materials and Methods Using a seed-based analysis of rest-fMRI with multiple template seeds, we identified functionally connected language regions in patients undergoing preoperative language mapping. Four language task paradigms (word, verb, picture, and semantics) were evaluated. We quantified the degree of overlap between language areas identified on rest-fMRI and task-fMRI, categorizing the results as more than 50% or less than 50% overlap. Results Seventy-seven percent of patients demonstrated an overlap exceeding 50% between rest- and task-fMRI maps, with the left Broca's area being the most frequently observed region of overlap. This finding was noted even in cases with lesions in Broca's or Wernicke's areas, highlighting the method's robustness. The verb task showed the best blood-oxygen-level dependent activity and overlap with rest-fMRI, highlighting its reliability. To identify a specific language area, the contralateral seed of the same area most commonly displayed connectivity with the area of interest. Conclusion Our findings demonstrate the potential of using rest-fMRI in accurately mapping eloquent language areas, in clinical settings The strong concordance observed, especially in the left Broca's area, underscores the reliability of this method. Further research and larger studies are essential to validate these results, potentially establishing the use of routine rest-fMRI, in clinical preoperative workup.

COVID-19-Associated Bone Marrow Necrosis-A Case Report.

We report, herein, a rare case of vertebral bone marrow necrosis in a patient at 1-month post-novel coronavirus disease 2019 (COVID-19) pneumonia complicated with disseminated intravascular coagulation (DIC). The commonly observed radiological features on the imaging modalities like computed tomography (CT), magnetic resonance imaging (MRI), and 18-F fluorodeoxyglucose positron emission tomography (FDG PET) have been discussed here followed by a brief discussion on the role of in-phase and opposed-phase imaging in differentiating the disease from malignant infiltrative pathologies. Histopathological findings on bone marrow smear that confirm the diagnosis have also been illustrated.

Imaging & neuropsychological changes in brain with spiritual practice: A pilot study.

BACKGROUND & OBJECTIVES: Some studies have systematically assessed the effects of spiritual practice (SP) on the brain using combined neuropsychological testing and functional imaging. The objective of the present study was to compare imaging and neuropsychological changes in healthy individuals after SP and those with only physical exercise. METHODS: Healthy adult male volunteers, aged 25-45 yr were randomized into two groups. Group 1 (SP group) underwent the SP and group 2 (controls) did brisk walk for 30 min daily. Detailed neuropsychological evaluation, resting-state functional magnetic resonance imaging (fMRI) and brain 99mTc ethyl cysteinate dimer single-photon emission computed tomography (SPECT) were carried out for both groups before and three months after intervention. RESULTS: Post-intervention, resting state fMRI showed increased connections of left precuneus (in the posterior cingulate cortex area of default mode network) in group 1 and increased left frontal connections in group 2. The neuropsychological tests showed significant improvement in 'Speed of Processing' (Digit Symbol Test) in group 1 and in Focused Attention (Trail Making A) in group 2. The SPECT data in group 1 showed significant improvement in perfusion of the frontal areas, with relatively lesser improvement in parietal areas. Group 2 showed significant improvement in perfusion predominantly in parietal areas, as compared to frontal areas. In addition, significantly improved mood was reported by group 1 and not by group 2. INTERPRETATION & CONCLUSIONS: This pilot study shows important functional imaging and neuropsychological changes in the brain with SP.

fMRI for mapping language networks in neurosurgical cases.

Evaluating language has been a long-standing application in functional magnetic resonance imaging (fMRI) studies, both in research and clinical circumstances, and still provides challenges. Localization of eloquent areas is important in neurosurgical cases, so that there is least possible damage to these areas during surgery, maintaining their function postoperatively, therefore providing good quality of life to the patient. Preoperative fMRI study is a non-invasive tool to localize the eloquent areas, including language, with other traditional methods generally used being invasive and at times perilous. In this article, we describe methods and various paradigms to study the language areas, in clinical neurosurgical cases, along with illustrations of cases from our institute.

Pictorial review of MRI/CT Scan in congenital temporal bone anomalies, in patients for cochlear implant.

High-resolution CT scan (HRCT) and MRI are routinely performed prior to cochlear implant surgery. These modalities help assess the status of the inner ear structures. A few patients have significant anomalies, which need to be assessed and understood in detail. We present a pictorial essay of these anomalies and described our HRCT and MRI techniques in patients being imaged prior to surgery.