A novel data-driven approach to preoperative mapping of functional cortex using resting-state functional magnetic resonance imaging.
Neurosurgery
; 73(6): 969-82; discussion 982-3, 2013 Dec.
Article
em En
| MEDLINE
| ID: mdl-24264234
ABSTRACT
BACKGROUND:
Recent findings associated with resting-state cortical networks have provided insight into the brain's organizational structure. In addition to their neuroscientific implications, the networks identified by resting-state functional magnetic resonance imaging (rs-fMRI) may prove useful for clinical brain mapping.OBJECTIVE:
To demonstrate that a data-driven approach to analyze resting-state networks (RSNs) is useful in identifying regions classically understood to be eloquent cortex as well as other functional networks.METHODS:
This study included 6 patients undergoing surgical treatment for intractable epilepsy and 7 patients undergoing tumor resection. rs-fMRI data were obtained before surgery and 7 canonical RSNs were identified by an artificial neural network algorithm. Of these 7, the motor and language networks were then compared with electrocortical stimulation (ECS) as the gold standard in the epilepsy patients. The sensitivity and specificity for identifying these eloquent sites were calculated at varying thresholds, which yielded receiver-operating characteristic (ROC) curves and their associated area under the curve (AUC). RSNs were plotted in the tumor patients to observe RSN distortions in altered anatomy.RESULTS:
The algorithm robustly identified all networks in all patients, including those with distorted anatomy. When all ECS-positive sites were considered for motor and language, rs-fMRI had AUCs of 0.80 and 0.64, respectively. When the ECS-positive sites were analyzed pairwise, rs-fMRI had AUCs of 0.89 and 0.76 for motor and language, respectively.CONCLUSION:
A data-driven approach to rs-fMRI may be a new and efficient method for preoperative localization of numerous functional brain regions.
Texto completo:
1
Coleções:
01-internacional
Temas:
Geral
Base de dados:
MEDLINE
Assunto principal:
Algoritmos
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Processamento de Imagem Assistida por Computador
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Mapeamento Encefálico
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Córtex Cerebral
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Vias Neurais
Tipo de estudo:
Prognostic_studies
Limite:
Adult
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Neurosurgery
Ano de publicação:
2013
Tipo de documento:
Article