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

  • Clinical Article - Neurosurgical Techniques
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Abstract

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

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Download references

The authors would like to thank Jian-bing Shi and Zhong Yang for assembling the image database, Gen Xu for direct cortical stimulation, and Yan-yan Song for statistical analysis.

Author contributions

Study concept and design: Zhou and Wu. Processing of data: Qiu, Zhuang, Yao, Lu, Zhu, and Tang. Analysis and interpretation of data: Qiu and Yan. Drafting of the manuscript: Qiu and Yan. Critical revision of the manuscript for important intellectual content: Wu, Mao and Zhou.

Financial Disclosure

None reported.

Funding

This work was funded by the National Natural Science Foundation of China (Project No. 81271517, 81171295), The National Key Technology R&D Program of China (No. 2014BAI04B05), and Shanghai Municipal Health Bureau (XBR2011022).

Conflict of interest

None.

Author information

Authors and Affiliations

  1. Neurological Surgery Department, Huashan Hospital, Shanghai Medical College, Fudan University, 12#, Wulumuqi Zhong Road, Shanghai, 200040, People’s Republic of China

    Tian-ming Qiu, Jun-feng Lu, Feng-ping Zhu, Ying Mao & Liang-fu Zhou

  2. The Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, 10962, USA

    Chao-gan Yan

  3. The Phyllis Green and Randolph Cowen Institute for Pediatric Neuroscience, New York University Child Study Center, New York, NY, 10016, USA

    Chao-gan Yan

  4. Department of Radiology, Huashan Hospital, Fudan University, Shanghai, 200040, China

    Wei-jun Tang

  5. Glioma Surgery Division, Neurological Surgery Department, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, 200040, China

    Jin-song Wu, Dong-xiao Zhuang & Cheng-jun Yao

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  1. Tian-ming Qiu
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Correspondence to Liang-fu Zhou.

Additional information

Tian-ming Qiu and Chao-gan Yan contributed equally to this paper.

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Qiu, Tm., Yan, Cg., Tang, Wj. et al. Localizing hand motor area using resting-state fMRI: validated with direct cortical stimulation. Acta Neurochir 156, 2295–2302 (2014). https://doi.org/10.1007/s00701-014-2236-0

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  • DOI: https://doi.org/10.1007/s00701-014-2236-0

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