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Sun H, Vachha B, Laino ME, Jenabi M, Flynn JR, Zhang Z, Holodny AI, Peck KK. Decreased Hand Motor Resting-State Functional Connectivity in Patients with Glioma: Analysis of Factors including Neurovascular Uncoupling. Radiology 2020; 294:610-621. [PMID: 31934827 DOI: 10.1148/radiol.2019190089] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background Resting-state functional MRI holds substantial potential for clinical application, but limitations exist in current understanding of how tumors exert local effects on resting-state functional MRI readings. Purpose To investigate the association between tumors, tumor characteristics, and changes in resting-state connectivity, to explore neurovascular uncoupling as a mechanism underlying these changes, and to evaluate seeding methodologies as a clinical tool. Materials and Methods Institutional review board approval was obtained for this HIPAA-compliant observational retrospective study of patients with glioma who underwent MRI and resting-state functional MRI between January 2016 and July 2017. Interhemispheric symmetry of connectivity was assessed in the hand motor region, incorporating tumor position, perfusion, grade, and connectivity generated from seed-based correlation. Statistical analysis was performed by using one-tailed t tests, Wilcoxon rank sum tests, one-way analysis of variance, Pearson correlation, and Spearman rank correlation, with significance at P < .05. Results Data in a total of 45 patients with glioma (mean age, 51.3 years ± 14.3 [standard deviation]) were compared with those in 10 healthy control subjects (mean age, 50.3 years ± 17.2). Patients showed loss of symmetry in measures of hand motor resting-state connectivity compared with control subjects (P < .05). Tumor distance from the ipsilateral hand motor (IHM) region correlated with the degree (R = 0.38, P = .01) and strength (R = 0.33, P = .03) of resting-state connectivity. In patients with World Health Organization grade IV glioblastomas 40 mm or less from the IHM region, loss of symmetry in strength of resting-state connectivity was correlated with tumor perfusion (R = 0.74, P < .01). In patients with gliomas 40 mm or less from the IHM region, seeding the nontumor hemisphere yielded less asymmetric hand motor resting-state connectivity than seeding the tumor hemisphere (connectivity seeded:contralateral = 1.34 nontumor vs 1.38 tumor hemisphere seeded; P = .03, false discovery rate threshold = 0.01). Conclusion Hand motor resting-state connectivity was less symmetrical in a tumor distance-dependent manner in patients with glioma. Differences in resting-state connectivity may be false-negative results driven by a neurovascular uncoupling mechanism. Seeding from the nontumor hemisphere may attenuate asymmetry in patients with tumors near ipsilateral hand motor cortices. © RSNA, 2020 Online supplemental material is available for this article.
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Affiliation(s)
- Herie Sun
- From the Departments of Radiology (H.S., B.V., M.E.L., M.J., A.I.H., K.K.P.), Medical Physics (K.K.P.), and Epidemiology-Biostatistics (J.R.F., Z.Z.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY 10065; Department of Radiology, Catholic University of the Sacred Heart-A. Gemelli Hospital, Rome, Italy (M.E.L.); Department of Neuroscience, Weill Cornell Graduate School of the Medical Sciences, New York, NY (A.I.H.); and Department of Radiology, Weill Medical College of Cornell University, New York, NY (A.I.H.)
| | - Behroze Vachha
- From the Departments of Radiology (H.S., B.V., M.E.L., M.J., A.I.H., K.K.P.), Medical Physics (K.K.P.), and Epidemiology-Biostatistics (J.R.F., Z.Z.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY 10065; Department of Radiology, Catholic University of the Sacred Heart-A. Gemelli Hospital, Rome, Italy (M.E.L.); Department of Neuroscience, Weill Cornell Graduate School of the Medical Sciences, New York, NY (A.I.H.); and Department of Radiology, Weill Medical College of Cornell University, New York, NY (A.I.H.)
| | - Maria E Laino
- From the Departments of Radiology (H.S., B.V., M.E.L., M.J., A.I.H., K.K.P.), Medical Physics (K.K.P.), and Epidemiology-Biostatistics (J.R.F., Z.Z.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY 10065; Department of Radiology, Catholic University of the Sacred Heart-A. Gemelli Hospital, Rome, Italy (M.E.L.); Department of Neuroscience, Weill Cornell Graduate School of the Medical Sciences, New York, NY (A.I.H.); and Department of Radiology, Weill Medical College of Cornell University, New York, NY (A.I.H.)
| | - Mehrnaz Jenabi
- From the Departments of Radiology (H.S., B.V., M.E.L., M.J., A.I.H., K.K.P.), Medical Physics (K.K.P.), and Epidemiology-Biostatistics (J.R.F., Z.Z.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY 10065; Department of Radiology, Catholic University of the Sacred Heart-A. Gemelli Hospital, Rome, Italy (M.E.L.); Department of Neuroscience, Weill Cornell Graduate School of the Medical Sciences, New York, NY (A.I.H.); and Department of Radiology, Weill Medical College of Cornell University, New York, NY (A.I.H.)
| | - Jessica R Flynn
- From the Departments of Radiology (H.S., B.V., M.E.L., M.J., A.I.H., K.K.P.), Medical Physics (K.K.P.), and Epidemiology-Biostatistics (J.R.F., Z.Z.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY 10065; Department of Radiology, Catholic University of the Sacred Heart-A. Gemelli Hospital, Rome, Italy (M.E.L.); Department of Neuroscience, Weill Cornell Graduate School of the Medical Sciences, New York, NY (A.I.H.); and Department of Radiology, Weill Medical College of Cornell University, New York, NY (A.I.H.)
| | - Zhigang Zhang
- From the Departments of Radiology (H.S., B.V., M.E.L., M.J., A.I.H., K.K.P.), Medical Physics (K.K.P.), and Epidemiology-Biostatistics (J.R.F., Z.Z.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY 10065; Department of Radiology, Catholic University of the Sacred Heart-A. Gemelli Hospital, Rome, Italy (M.E.L.); Department of Neuroscience, Weill Cornell Graduate School of the Medical Sciences, New York, NY (A.I.H.); and Department of Radiology, Weill Medical College of Cornell University, New York, NY (A.I.H.)
| | - Andrei I Holodny
- From the Departments of Radiology (H.S., B.V., M.E.L., M.J., A.I.H., K.K.P.), Medical Physics (K.K.P.), and Epidemiology-Biostatistics (J.R.F., Z.Z.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY 10065; Department of Radiology, Catholic University of the Sacred Heart-A. Gemelli Hospital, Rome, Italy (M.E.L.); Department of Neuroscience, Weill Cornell Graduate School of the Medical Sciences, New York, NY (A.I.H.); and Department of Radiology, Weill Medical College of Cornell University, New York, NY (A.I.H.)
| | - Kyung K Peck
- From the Departments of Radiology (H.S., B.V., M.E.L., M.J., A.I.H., K.K.P.), Medical Physics (K.K.P.), and Epidemiology-Biostatistics (J.R.F., Z.Z.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY 10065; Department of Radiology, Catholic University of the Sacred Heart-A. Gemelli Hospital, Rome, Italy (M.E.L.); Department of Neuroscience, Weill Cornell Graduate School of the Medical Sciences, New York, NY (A.I.H.); and Department of Radiology, Weill Medical College of Cornell University, New York, NY (A.I.H.)
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52
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Zhang L. Glioma characterization based on magnetic resonance imaging: Challenge overview and future perspective. GLIOMA 2020. [DOI: 10.4103/glioma.glioma_9_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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53
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Rigolo L, Essayed WI, Tie Y, Norton I, Mukundan S, Golby A. Intraoperative Use of Functional MRI for Surgical Decision Making after Limited or Infeasible Electrocortical Stimulation Mapping. J Neuroimaging 2019; 30:184-191. [PMID: 31867823 DOI: 10.1111/jon.12683] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 11/09/2019] [Accepted: 11/11/2019] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND AND PURPOSE Functional magnetic resonance imaging (fMRI) is becoming widely recognized as a key component of preoperative neurosurgical planning, although intraoperative electrocortical stimulation (ECS) is considered the gold standard surgical brain mapping method. However, acquiring and interpreting ECS results can sometimes be challenging. This retrospective study assesses whether intraoperative availability of fMRI impacted surgical decision-making when ECS was problematic or unobtainable. METHODS Records were reviewed for 191 patients who underwent presurgical fMRI with fMRI loaded into the neuronavigation system. Four patients were excluded as a bur-hole biopsy was performed. Imaging was acquired at 3 Tesla and analyzed using the general linear model with significantly activated pixels determined via individually determined thresholds. fMRI maps were displayed intraoperatively via commercial neuronavigation systems. RESULTS Seventy-one cases were planned ECS; however, 18 (25.35%) of these procedures were either not attempted or aborted/limited due to: seizure (10), patient difficulty cooperating with the ECS mapping (4), scarring/limited dural opening (3), or dural bleeding (1). In all aborted/limited ECS cases, the surgeon continued surgery using fMRI to guide surgical decision-making. There was no significant difference in the incidence of postoperative deficits between cases with completed ECS and those with limited/aborted ECS. CONCLUSIONS Preoperative fMRI allowed for continuation of surgery in over one-fourth of patients in which planned ECS was incomplete or impossible, without a significantly different incidence of postoperative deficits compared to the patients with completed ECS. This demonstrates additional value of fMRI beyond presurgical planning, as fMRI data served as a backup method to ECS.
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Affiliation(s)
- Laura Rigolo
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.,Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Walid Ibn Essayed
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Yanmei Tie
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Isaiah Norton
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Srinivasan Mukundan
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Alexandra Golby
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.,Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
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54
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Utilization of functional MRI language paradigms for pre-operative mapping: a systematic review. Neuroradiology 2019; 62:353-367. [DOI: 10.1007/s00234-019-02322-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Accepted: 11/08/2019] [Indexed: 12/18/2022]
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Role of Functional Imaging Techniques to Assess Motor and Language Cortical Plasticity in Glioma Patients: A Systematic Review. Neural Plast 2019; 2019:4056436. [PMID: 31814822 PMCID: PMC6878806 DOI: 10.1155/2019/4056436] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 10/05/2019] [Indexed: 01/19/2023] Open
Abstract
Cerebral plasticity is the ability of the central nervous system to reorganize itself in response to different injuries. The reshaping of functional areas is a crucial mechanism to compensate for damaged function. It is acknowledged that functional remodeling of cortical areas may occur also in glioma patients. Principal limits of previous investigations on cortical plasticity of motor and language functions included scarce reports of longitudinal evaluations and limited sample sizes. This systematic review is aimed at elucidating cortical brain plasticity for motor and language functions, in adult glioma patients, by means of preoperative and intraoperative mapping techniques. We systematically reviewed the literature for prospective studies, assessing cortical plasticity of motor and language functions in low-grade and high-grade gliomas. Eight longitudinal studies investigated cortical plasticity, evaluated by motor and language task-based functional MRI (fMRI), motor navigated transcranial magnetic stimulation (n-TMS), and intraoperative mapping with cortical direct electrocortical stimulation (DES) of language and motor function. Motor function reorganization appeared relatively limited and mostly characterized by intrahemispheric functional changes, including secondary motor cortices. On the other hand, a high level of functional reshaping was found for language function in DES studies. Occurrence of cortical functional reorganization of language function was described focusing on the intrahemispheric recruitment of perilesional areas. However, the association between these functional patterns and recovery of motor and language deficits still remains partially clear. A number of relevant methodological issues possibly affecting the finding generalization emerged, such as the complexity of plasticity outcome measures and the lack of large longitudinal studies. Future studies are required to further confirm these evidences on cortical plasticity in larger samples, combining both functional imaging and intraoperative mapping techniques in longitudinally evaluations.
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Vakamudi K, Posse S, Jung R, Cushnyr B, Chohan MO. Real-time presurgical resting-state fMRI in patients with brain tumors: Quality control and comparison with task-fMRI and intraoperative mapping. Hum Brain Mapp 2019; 41:797-814. [PMID: 31692177 PMCID: PMC7268088 DOI: 10.1002/hbm.24840] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 10/09/2019] [Accepted: 10/10/2019] [Indexed: 12/11/2022] Open
Abstract
Resting-state functional magnetic resonance imaging (rsfMRI) is a promising task-free functional imaging approach, which may complement or replace task-based fMRI (tfMRI) in patients who have difficulties performing required tasks. However, rsfMRI is highly sensitive to head movement and physiological noise, and validation relative to tfMRI and intraoperative electrocortical mapping is still necessary. In this study, we investigate (a) the feasibility of real-time rsfMRI for presurgical mapping of eloquent networks with monitoring of data quality in patients with brain tumors and (b) rsfMRI localization of eloquent cortex compared with tfMRI and intraoperative electrocortical stimulation (ECS) in retrospective analysis. Five brain tumor patients were studied with rsfMRI and tfMRI on a clinical 3T scanner using MultiBand(8)-echo planar imaging (EPI) with repetition time: 400 ms. Moving-averaged sliding-window correlation analysis with regression of motion parameters and signals from white matter and cerebrospinal fluid was used to map sensorimotor and language resting-state networks. Data quality monitoring enabled rapid optimization of scan protocols, early identification of task noncompliance, and head movement-related false-positive connectivity to determine scan continuation or repetition. Sensorimotor and language resting-state networks were identifiable within 1 min of scan time. The Euclidean distance between ECS and rsfMRI connectivity and task-activation in motor cortex, Broca's, and Wernicke's areas was 5-10 mm, with the exception of discordant rsfMRI and ECS localization of Wernicke's area in one patient due to possible cortical reorganization and/or altered neurovascular coupling. This study demonstrates the potential of real-time high-speed rsfMRI for presurgical mapping of eloquent cortex with real-time data quality control, and clinically acceptable concordance of rsfMRI with tfMRI and ECS localization.
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Affiliation(s)
- Kishore Vakamudi
- Department of Neurology, University of New Mexico, Albuquerque, New Mexico
| | - Stefan Posse
- Department of Neurology, University of New Mexico, Albuquerque, New Mexico.,Department of Physics and Astronomy, University of New Mexico, Albuquerque, New Mexico
| | - Rex Jung
- Department of Neurosurgery, University of New Mexico, Albuquerque, New Mexico
| | - Brad Cushnyr
- Department of Radiology, University of New Mexico, Albuquerque, New Mexico
| | - Muhammad O Chohan
- Department of Neurosurgery, University of New Mexico, Albuquerque, New Mexico
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Abstract
Task-based functional magnetic resonance imaging (fMRI) for the presurgical assessment of eloquent cortex is increasingly relied upon by surgeons, neurologists, and radiologists. The utility of fMRI stems from the lack of correlation between topographic anatomy and functional anatomy. fMRI can noninvasively reveal the functional anatomy of a given individual thereby allowing the surgeon to choose the most appropriate surgical trajectory, attain the most complete resection, and offer the best chance of preserving function. This dissociation between function and topography is even more critical to understand when disease distorts normal anatomic relations and when chronic evolution of pathology leads to reorganization of cortical function as can be seen with seizures or slow growing tumors. fMRI can demonstrate the functional anatomy of language, motor, vision, and memory systems. Accurate interpretation not only requires knowledge of the expected patterns of activations in the regions of interest but also demands an understanding of the many adjacent "bystander" activations that represent participatory neural activity but not the eloquent region in question. In addition, fMRI interpretation requires an understanding of the limitations of this technique when expected activity is either missing or seemingly displaced in location.
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58
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Wu CW, Tsai PJ, Chen SCJ, Li CW, Hsu AL, Wu HY, Ko YT, Hung PC, Chang CY, Lin CP, Lane TJ, Chen CY. Indication of dynamic neurovascular coupling from inconsistency between EEG and fMRI indices across sleep–wake states. Sleep Biol Rhythms 2019. [DOI: 10.1007/s41105-019-00232-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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59
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Sprugnoli G, Monti L, Lippa L, Neri F, Mencarelli L, Ruffini G, Salvador R, Oliveri G, Batani B, Momi D, Cerase A, Pascual-Leone A, Rossi A, Rossi S, Santarnecchi E. Reduction of intratumoral brain perfusion by noninvasive transcranial electrical stimulation. SCIENCE ADVANCES 2019; 5:eaau9309. [PMID: 31453319 PMCID: PMC6693907 DOI: 10.1126/sciadv.aau9309] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Accepted: 07/10/2019] [Indexed: 05/04/2023]
Abstract
Malignant brain neoplasms have a poor prognosis despite aggressive treatments. Animal models and evidence from human bodily tumors reveal that sustained reduction in tumor perfusion via electrical stimulation promotes tumor necrosis, therefore possibly representing a therapeutic option for patients with brain tumors. Here, we demonstrate that transcranial electrical stimulation (tES) allows to safely and noninvasively reduce intratumoral perfusion in humans. Selected patients with glioblastoma or metastasis underwent tES, while perfusion was assessed using magnetic resonance imaging. Multichannel tES was applied according to personalized biophysical modeling, to maximize the induced electrical field over the solid tumor mass. All patients completed the study and tolerated the procedure without adverse effects, with tES selectively reducing the perfusion of the solid tumor. Results potentially open the door to noninvasive therapeutic interventions in brain tumors based on stand-alone tES or its combination with other available therapies.
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Affiliation(s)
- G. Sprugnoli
- Brain Investigation and Neuromodulation Laboratory, Department of Medicine, Surgery and Neuroscience, Unit of Neurology and Clinical Neurophysiology, Siena Medical School, Siena, Italy
| | - L. Monti
- Unit of Neuroimaging and Neurointervention, “Santa Maria alle Scotte” Medical Center, Siena, Italy
| | - L. Lippa
- Unit of Neurosurgery, “Santa Maria alle Scotte” Medical Center, Siena, Italy
| | - F. Neri
- Brain Investigation and Neuromodulation Laboratory, Department of Medicine, Surgery and Neuroscience, Unit of Neurology and Clinical Neurophysiology, Siena Medical School, Siena, Italy
| | - L. Mencarelli
- Brain Investigation and Neuromodulation Laboratory, Department of Medicine, Surgery and Neuroscience, Unit of Neurology and Clinical Neurophysiology, Siena Medical School, Siena, Italy
| | | | | | - G. Oliveri
- Unit of Neurosurgery, “Santa Maria alle Scotte” Medical Center, Siena, Italy
| | - B. Batani
- Unit of Neurosurgery, “Santa Maria alle Scotte” Medical Center, Siena, Italy
| | - D. Momi
- Brain Investigation and Neuromodulation Laboratory, Department of Medicine, Surgery and Neuroscience, Unit of Neurology and Clinical Neurophysiology, Siena Medical School, Siena, Italy
| | - A. Cerase
- Unit of Neuroimaging and Neurointervention, “Santa Maria alle Scotte” Medical Center, Siena, Italy
| | - A. Pascual-Leone
- Berenson-Allen Center for Noninvasive Brain Stimulation, Beth Israel Medical Center, Harvard Medical School, Boston, MA, USA
- Institut Guttmann, Universitat Autonoma Barcelona, Barcelona, Spain
| | - A. Rossi
- Brain Investigation and Neuromodulation Laboratory, Department of Medicine, Surgery and Neuroscience, Unit of Neurology and Clinical Neurophysiology, Siena Medical School, Siena, Italy
- Department of Medicine, Surgery and Neuroscience, Human Physiology Section, Siena Medical School, Siena, Italy
| | - S. Rossi
- Brain Investigation and Neuromodulation Laboratory, Department of Medicine, Surgery and Neuroscience, Unit of Neurology and Clinical Neurophysiology, Siena Medical School, Siena, Italy
- Department of Medicine, Surgery and Neuroscience, Human Physiology Section, Siena Medical School, Siena, Italy
| | - E. Santarnecchi
- Brain Investigation and Neuromodulation Laboratory, Department of Medicine, Surgery and Neuroscience, Unit of Neurology and Clinical Neurophysiology, Siena Medical School, Siena, Italy
- Berenson-Allen Center for Noninvasive Brain Stimulation, Beth Israel Medical Center, Harvard Medical School, Boston, MA, USA
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Unadkat P, Fumagalli L, Rigolo L, Vangel MG, Young GS, Huang R, Mukundan S, Golby A, Tie Y. Functional MRI Task Comparison for Language Mapping in Neurosurgical Patients. J Neuroimaging 2019; 29:348-356. [PMID: 30648771 PMCID: PMC6506353 DOI: 10.1111/jon.12597] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 12/07/2018] [Accepted: 12/10/2018] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND AND PURPOSE Language task-based functional MRI (fMRI) is increasingly used for presurgical planning in patients with brain lesions. Different paradigms elicit activations of different components of the language network. The aim of this study is to optimize fMRI clinical usage by comparing the effectiveness of three language tasks for language lateralization and localization in a large group of patients with brain lesions. METHODS We analyzed fMRI data from a sequential retrospective cohort of 51 patients with brain lesions who underwent presurgical fMRI language mapping. We compared the effectiveness of three language tasks (Antonym Generation, Sentence Completion (SC), and Auditory Naming) for lateralizing language function and for activating cortex within patient-specific regions-of-interest representing eloquent language areas, and assessed the degree of spatial overlap of the areas of activation elicited by each task. RESULTS The tasks were similarly effective for lateralizing language within the anterior language areas. The SC task produced higher laterality indices within the posterior language areas and had a significantly higher agreement with the clinical report. Dice coefficients between the task pairs were in the range of .351-.458, confirming substantial variation in the components of the language network activated by each task. CONCLUSIONS SC task consistently produced large activations within the dominant hemisphere and was more effective for lateralizing language within the posterior language areas. The low degree of spatial overlap among the tasks strongly supports the practice of using a battery of tasks to help the surgeon to avoid eloquent language areas.
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Affiliation(s)
| | | | - Laura Rigolo
- From the Department of Neurosurgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA (PU, LF, LR, AG, YT); Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA (PU, MGV, GSY, RH, SM, AG); School of Medicine and Surgery, Universitá degli Studi di Milano-Bicocca, Milan, Italy (LF); and Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA (MGV)
| | - Mark G. Vangel
- From the Department of Neurosurgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA (PU, LF, LR, AG, YT); Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA (PU, MGV, GSY, RH, SM, AG); School of Medicine and Surgery, Universitá degli Studi di Milano-Bicocca, Milan, Italy (LF); and Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA (MGV)
| | - Geoffrey S. Young
- From the Department of Neurosurgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA (PU, LF, LR, AG, YT); Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA (PU, MGV, GSY, RH, SM, AG); School of Medicine and Surgery, Universitá degli Studi di Milano-Bicocca, Milan, Italy (LF); and Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA (MGV)
| | - Raymond Huang
- From the Department of Neurosurgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA (PU, LF, LR, AG, YT); Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA (PU, MGV, GSY, RH, SM, AG); School of Medicine and Surgery, Universitá degli Studi di Milano-Bicocca, Milan, Italy (LF); and Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA (MGV)
| | - Srinivasan Mukundan
- From the Department of Neurosurgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA (PU, LF, LR, AG, YT); Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA (PU, MGV, GSY, RH, SM, AG); School of Medicine and Surgery, Universitá degli Studi di Milano-Bicocca, Milan, Italy (LF); and Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA (MGV)
| | - Alexandra Golby
- From the Department of Neurosurgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA (PU, LF, LR, AG, YT); Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA (PU, MGV, GSY, RH, SM, AG); School of Medicine and Surgery, Universitá degli Studi di Milano-Bicocca, Milan, Italy (LF); and Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA (MGV)
| | - Yanmei Tie
- From the Department of Neurosurgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA (PU, LF, LR, AG, YT); Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA (PU, MGV, GSY, RH, SM, AG); School of Medicine and Surgery, Universitá degli Studi di Milano-Bicocca, Milan, Italy (LF); and Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA (MGV)
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Agarwal S, Sair HI, Gujar S, Hua J, Lu H, Pillai JJ. Functional Magnetic Resonance Imaging Activation Optimization in the Setting of Brain Tumor-Induced Neurovascular Uncoupling Using Resting-State Blood Oxygen Level-Dependent Amplitude of Low Frequency Fluctuations. Brain Connect 2019; 9:241-250. [PMID: 30547681 DOI: 10.1089/brain.2017.0562] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
The goal of this study was to demonstrate that a novel resting state BOLD ALFF (amplitude of low frequency fluctuations)-based correction method can substantially enhance the detectability of motor task activation in the presence of tumor-induced neurovascular uncoupling (NVU). Twelve de novo brain tumor patients who underwent comprehensive clinical BOLD fMRI exams including task fMRI and resting state fMRI (rsfMRI) were evaluated. Each patient displayed decreased/absent task fMRI activation in the ipsilesional primary motor cortex in the absence of corresponding motor deficit or suboptimal task performance, consistent with NVU. Z-score maps for the motor tasks were obtained from general linear model (GLM) analysis (reflecting motor activation vs. rest). ALFF maps were calculated from rsfMRI data. Precentral and postcentral gyri in contralesional (CL) and ipsilesional (IL) hemispheres were parcellated using an Automated Anatomical Labeling (AAL) template for each patient. A novel ALFF-based correction method was used to identify the NVU affected voxels in the ipsilesional primary motor cortex (PMC), and a correction factor was applied to normalize the baseline Z-scores for these voxels. In all cases, substantially greater activation was seen on post-ALFF correction motor activation maps within the ipsilesional precentral gyri than in the pre-ALFF correction activation maps. We have demonstrated the feasibility of a new resting state ALFF-based technique for effective correction of brain tumor-related NVU in the primary motor cortex.
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Affiliation(s)
- Shruti Agarwal
- 1 Divisions of Neuroradiology and Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Haris I Sair
- 1 Divisions of Neuroradiology and Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Sachin Gujar
- 1 Divisions of Neuroradiology and Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Jun Hua
- 2 Divisions of MR Research, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland.,3 F. M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland
| | - Hanzhang Lu
- 2 Divisions of MR Research, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland.,3 F. M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland
| | - Jay J Pillai
- 1 Divisions of Neuroradiology and Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland.,4 Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
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Durner G, Pala A, Federle L, Grolik B, Wirtz CR, Coburger J. Comparison of hemispheric dominance and correlation of evoked speech responses between functional magnetic resonance imaging and navigated transcranial magnetic stimulation in language mapping. J Neurosurg Sci 2019; 63:106-113. [DOI: 10.23736/s0390-5616.18.04591-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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63
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Senarathna J, Yu H, Deng C, Zou AL, Issa JB, Hadjiabadi DH, Gil S, Wang Q, Tyler BM, Thakor NV, Pathak AP. A miniature multi-contrast microscope for functional imaging in freely behaving animals. Nat Commun 2019; 10:99. [PMID: 30626878 PMCID: PMC6327063 DOI: 10.1038/s41467-018-07926-z] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Accepted: 12/03/2018] [Indexed: 12/27/2022] Open
Abstract
Neurovascular coupling, cerebrovascular remodeling and hemodynamic changes are critical to brain function, and dysregulated in neuropathologies such as brain tumors. Interrogating these phenomena in freely behaving animals requires a portable microscope with multiple optical contrast mechanisms. Therefore, we developed a miniaturized microscope with: a fluorescence (FL) channel for imaging neural activity (e.g., GCaMP) or fluorescent cancer cells (e.g., 9L-GFP); an intrinsic optical signal (IOS) channel for imaging hemoglobin absorption (i.e., cerebral blood volume); and a laser speckle contrast (LSC) channel for imaging perfusion (i.e., cerebral blood flow). Following extensive validation, we demonstrate the microscope’s capabilities via experiments in unanesthetized murine brains that include: (i) multi-contrast imaging of neurovascular changes following auditory stimulation; (ii) wide-area tonotopic mapping; (iii) EEG-synchronized imaging during anesthesia recovery; and (iv) microvascular connectivity mapping over the life-cycle of a brain tumor. This affordable, flexible, plug-and-play microscope heralds a new era in functional imaging of freely behaving animals. Measuring multiple neurophysiologic variables usually requires bulky benchtop optical systems and working with anesthetized animals. Here the authors present a miniature portable microscope for neurovascular imaging in awake rodents, combining fluorescence, intrinsic optical signals and laser speckle contrast.
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Affiliation(s)
- Janaka Senarathna
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, 21205, USA
| | - Hang Yu
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, 21205, USA
| | - Callie Deng
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, 21205, USA
| | - Alice L Zou
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, 21205, USA
| | - John B Issa
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, 21205, USA
| | - Darian H Hadjiabadi
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, 21205, USA
| | - Stacy Gil
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, 21205, USA
| | - Qihong Wang
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, 21205, USA
| | - Betty M Tyler
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, 21205, USA
| | - Nitish V Thakor
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, 21205, USA
| | - Arvind P Pathak
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, 21205, USA. .,Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, 21205, USA.
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64
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Hsu AL, Hou P, Johnson JM, Wu CW, Noll KR, Prabhu SS, Ferguson SD, Kumar VA, Schomer DF, Hazle JD, Chen JH, Liu HL. IClinfMRI Software for Integrating Functional MRI Techniques in Presurgical Mapping and Clinical Studies. Front Neuroinform 2018; 12:11. [PMID: 29593520 PMCID: PMC5854683 DOI: 10.3389/fninf.2018.00011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Accepted: 02/23/2018] [Indexed: 01/25/2023] Open
Abstract
Task-evoked and resting-state (rs) functional magnetic resonance imaging (fMRI) techniques have been applied to the clinical management of neurological diseases, exemplified by presurgical localization of eloquent cortex, to assist neurosurgeons in maximizing resection while preserving brain functions. In addition, recent studies have recommended incorporating cerebrovascular reactivity (CVR) imaging into clinical fMRI to evaluate the risk of lesion-induced neurovascular uncoupling (NVU). Although each of these imaging techniques possesses its own advantage for presurgical mapping, a specialized clinical software that integrates the three complementary techniques and promptly outputs the analyzed results to radiology and surgical navigation systems in a clinical format is still lacking. We developed the Integrated fMRI for Clinical Research (IClinfMRI) software to facilitate these needs. Beyond the independent processing of task-fMRI, rs-fMRI, and CVR mapping, IClinfMRI encompasses three unique functions: (1) supporting the interactive rs-fMRI mapping while visualizing task-fMRI results (or results from published meta-analysis) as a guidance map, (2) indicating/visualizing the NVU potential on analyzed fMRI maps, and (3) exporting these advanced mapping results in a Digital Imaging and Communications in Medicine (DICOM) format that are ready to export to a picture archiving and communication system (PACS) and a surgical navigation system. In summary, IClinfMRI has the merits of efficiently translating and integrating state-of-the-art imaging techniques for presurgical functional mapping and clinical fMRI studies.
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Affiliation(s)
- Ai-Ling Hsu
- Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, United States.,Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taipei, Taiwan
| | - Ping Hou
- Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Jason M Johnson
- Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Changwei W Wu
- Graduate Institute of Humanities in Medicine, Taipei Medical University, Taipei, Taiwan
| | - Kyle R Noll
- Section of Neuropsychology, Department of Neuro-Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Sujit S Prabhu
- Department of Neurosurgery, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Sherise D Ferguson
- Department of Neurosurgery, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Vinodh A Kumar
- Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Donald F Schomer
- Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - John D Hazle
- Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Jyh-Horng Chen
- Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taipei, Taiwan
| | - Ho-Ling Liu
- Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
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Hadjiabadi DH, Pung L, Zhang J, Ward BD, Lim WT, Kalavar M, Thakor NV, Biswal BB, Pathak AP. Brain tumors disrupt the resting-state connectome. NEUROIMAGE-CLINICAL 2018; 18:279-289. [PMID: 29876248 PMCID: PMC5987800 DOI: 10.1016/j.nicl.2018.01.026] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Revised: 01/15/2018] [Accepted: 01/20/2018] [Indexed: 01/18/2023]
Abstract
Brain tumor patients often experience functional deficits that extend beyond the tumor site. While resting-state functional MRI (rsfMRI) has been used to map such functional connectivity changes in brain tumor patients, the interplay between abnormal tumor vasculature and the rsfMRI signal is still not well understood. Therefore, there is an exigent need for new tools to elucidate how the blood‑oxygenation-level-dependent (BOLD) rsfMRI signal is modulated in brain cancer. In this initial study, we explore the utility of a preclinical model for quantifying brain tumor-induced changes on the rsfMRI signal and resting-state brain connectivity. We demonstrate that brain tumors induce brain-wide alterations of resting-state networks that extend to the contralateral hemisphere, accompanied by global attenuation of the rsfMRI signal. Preliminary histology suggests that some of these alterations in brain connectivity may be attributable to tumor-related remodeling of the neurovasculature. Moreover, this work recapitulates clinical rsfMRI findings from brain tumor patients in terms of the effects of tumor size on the neurovascular microenvironment. Collectively, these results lay the foundation of a preclinical platform for exploring the usefulness of rsfMRI as a potential new biomarker in patients with brain cancer.
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Affiliation(s)
- Darian H Hadjiabadi
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - Leland Pung
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - Jiangyang Zhang
- Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - B D Ward
- Department of Biophysics, The Medical College of Wisconsin, Milwaukee, WI, USA
| | - Woo-Taek Lim
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - Meghana Kalavar
- Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Nitish V Thakor
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - Bharat B Biswal
- Department of Biomedical Engineering, The New Jersey Institute of Technology, Newark NJ, USA
| | - Arvind P Pathak
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, USA; Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, USA; Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
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