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Seghier ML. 7 T and beyond: toward a synergy between fMRI-based presurgical mapping at ultrahigh magnetic fields, AI, and robotic neurosurgery. Eur Radiol Exp 2024; 8:73. [PMID: 38945979 PMCID: PMC11214939 DOI: 10.1186/s41747-024-00472-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2024] [Accepted: 04/22/2024] [Indexed: 07/02/2024] Open
Abstract
Presurgical evaluation with functional magnetic resonance imaging (fMRI) can reduce postsurgical morbidity. Here, we discuss presurgical fMRI mapping at ultra-high magnetic fields (UHF), i.e., ≥ 7 T, in the light of the current growing interest in artificial intelligence (AI) and robot-assisted neurosurgery. The potential of submillimetre fMRI mapping can help better appreciate uncertainty on resection margins, though geometric distortions at UHF might lessen the accuracy of fMRI maps. A useful trade-off for UHF fMRI is to collect data with 1-mm isotropic resolution to ensure high sensitivity and subsequently a low risk of false negatives. Scanning at UHF might yield a revival interest in slow event-related fMRI, thereby offering a richer depiction of the dynamics of fMRI responses. The potential applications of AI concern denoising and artefact removal, generation of super-resolution fMRI maps, and accurate fusion or coregistration between anatomical and fMRI maps. The latter can benefit from the use of T1-weighted echo-planar imaging for better visualization of brain activations. Such AI-augmented fMRI maps would provide high-quality input data to robotic surgery systems, thereby improving the accuracy and reliability of robot-assisted neurosurgery. Ultimately, the advancement in fMRI at UHF would promote clinically useful synergies between fMRI, AI, and robotic neurosurgery.Relevance statement This review highlights the potential synergies between fMRI at UHF, AI, and robotic neurosurgery in improving the accuracy and reliability of fMRI-based presurgical mapping.Key points• Presurgical fMRI mapping at UHF improves spatial resolution and sensitivity.• Slow event-related designs offer a richer depiction of fMRI responses dynamics.• AI can support denoising, artefact removal, and generation of super-resolution fMRI maps.• AI-augmented fMRI maps can provide high-quality input data to robotic surgery systems.
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Affiliation(s)
- Mohamed L Seghier
- Department of Biomedical Engineering and Biotechnology, Khalifa University of Science and Technology, Abu Dhabi, UAE.
- Healtcare Engineering Innovation Center (HEIC), Khalifa University of Science and Technology, Abu Dhabi, UAE.
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Cai S, Liang Y, Wang Y, Fan Z, Qi Z, Liu Y, Chen F, Jiang C, Shi Z, Wang L, Zhang L. Shared and malignancy-specific functional plasticity of dynamic brain properties for patients with left frontal glioma. Cereb Cortex 2024; 34:bhad445. [PMID: 38011109 DOI: 10.1093/cercor/bhad445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 11/01/2023] [Accepted: 11/02/2023] [Indexed: 11/29/2023] Open
Abstract
The time-varying brain activity may parallel the disease progression of cerebral glioma. Assessment of brain dynamics would better characterize the pathological profile of glioma and the relevant functional remodeling. This study aims to investigate the dynamic properties of functional networks based on sliding-window approach for patients with left frontal glioma. The generalized functional plasticity due to glioma was characterized by reduced dynamic amplitude of low-frequency fluctuation of somatosensory networks, reduced dynamic functional connectivity between homotopic regions mainly involving dorsal attention network and subcortical nuclei, and enhanced subcortical dynamic functional connectivity. Malignancy-specific functional remodeling featured a chaotic modification of dynamic amplitude of low-frequency fluctuation and dynamic functional connectivity for low-grade gliomas, and attenuated dynamic functional connectivity of the intrahemispheric cortico-subcortical connections and reduced dynamic amplitude of low-frequency fluctuation of the bilateral caudate for high-grade gliomas. Network dynamic activity was clustered into four distinct configuration states. The occurrence and dwell time of the weakly connected state were reduced in patients' brains. Support vector machine model combined with predictive dynamic features achieved an averaged accuracy of 87.9% in distinguishing low- and high-grade gliomas. In conclusion, dynamic network properties are highly predictive of the malignant grade of gliomas, thus could serve as new biomarkers for disease characterization.
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Affiliation(s)
- Siqi Cai
- Paul. C. Lauterbur Research Centers for Biomedical Imaging, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong 518055, China
- University of Chinese Academy of Sciences, Beijing 100049, China
| | - Yuchao Liang
- Department of Neurosurgery, Beijing Tiantan Hospital of Capital Medical University, Beijing 10070, China
| | - Yinyan Wang
- Department of Neurosurgery, Beijing Tiantan Hospital of Capital Medical University, Beijing 10070, China
| | - Zhen Fan
- Department of Neurosurgery, Huashan Hospital of Fudan University, Shanghai 200040, China
| | - Zengxin Qi
- Department of Neurosurgery, Huashan Hospital of Fudan University, Shanghai 200040, China
| | - Yufei Liu
- Department of Neurosurgery, Shenzhen Second People's Hospital, Shenzhen, Guangdong 518025, China
| | - Fanfan Chen
- Department of Neurosurgery, Shenzhen Second People's Hospital, Shenzhen, Guangdong 518025, China
| | - Chunxiang Jiang
- Paul. C. Lauterbur Research Centers for Biomedical Imaging, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong 518055, China
| | - Zhifeng Shi
- Department of Neurosurgery, Huashan Hospital of Fudan University, Shanghai 200040, China
| | - Lei Wang
- Department of Neurosurgery, Beijing Tiantan Hospital of Capital Medical University, Beijing 10070, China
| | - Lijuan Zhang
- Paul. C. Lauterbur Research Centers for Biomedical Imaging, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong 518055, China
- University of Chinese Academy of Sciences, Beijing 100049, China
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Ahmed SR, Jenabi M, Gene M, Moreno R, Peck KK, Holodny A. Power spectral analysis can determine language laterality from resting-state functional MRI data in healthy controls. J Neuroimaging 2023; 33:661-670. [PMID: 37032593 PMCID: PMC10523910 DOI: 10.1111/jon.13105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 03/27/2023] [Accepted: 03/27/2023] [Indexed: 04/11/2023] Open
Abstract
BACKGROUND AND PURPOSE Resting-state functional magnetic resonance imaging (rsfMRI) has been proposed as an alternative to task-based fMRI including clinical situations such as preoperative brain tumor planning, due to advantages including ease of performance and time savings. However, one of its drawbacks is the limited ability to accurately lateralize language function. METHODS Using the rsfMRI data of healthy controls, we carried out a power spectra analysis on three regions of interest (ROIs): Broca's area (BA) in the frontal cortex for language, hand motor (HM) area in the primary motor cortex, and the primary visual cortex (V1). Spike removal, motion correction, linear trend removal, and spatial smoothing were applied. Spontaneous low-frequency fluctuations (0.01-0.1 Hz) were filtered to enable functional integration. RESULTS BA showed greater power on the left hemisphere relative to the right (p = .0055), while HM (p = .1563) and V1 (p = .4681) were not statistically significant. A novel index, termed the power laterality index (PLI), computed to estimate the degree of power lateralization for each brain region, revealed a statistically significant difference between BA and V1 (p < .00001), where V1 was used as a control since the primary visual cortex does not lateralize. Validation studies used to compare PLI to a laterality index computed using phonemic fluency, a task-based, language fMRI paradigm, demonstrated good correlation. CONCLUSIONS The power spectra for BA revealed left language lateralization, which was not replicated in HM or V1. This work demonstrates the feasibility and validity of an ROI-based power spectra analysis on rsfMRI data for language lateralization.
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Affiliation(s)
- Syed Rakin Ahmed
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, US
- Harvard Graduate Program in Biophysics, Harvard Medical School, Harvard University, Cambridge, MA, US
- Geisel School of Medicine at Dartmouth, Dartmouth College, Hanover, NH, US
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Boston, MA, US
- Broad Institute of MIT and Harvard, Cambridge, MA, US
| | - Mehrnaz Jenabi
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, US
| | - Madeleine Gene
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, US
| | - Raquel Moreno
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, US
| | - Kyung K. Peck
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, US
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY, US
| | - Andrei Holodny
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, US
- Brain Tumor Center, Memorial Sloan Kettering Cancer Center, New York, NY, US
- Department of Radiology, Weill Medical College of Cornell University, New York, NY, US
- Department of Neuroscience, Weill-Cornell Graduate School of the Medical Sciences, New York, NY, US
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Quinones A, Jenabi M, Pasquini L, Peck KK, Moss NS, Brennan C, Tabar V, Holodny A. Use of longitudinal functional MRI to demonstrate translocation of language function in patients with brain tumors. J Neurosurg 2022:1-9. [DOI: 10.3171/2022.10.jns221212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 10/11/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVE
The ability of functional MRI (fMRI) to localize patient-specific eloquent areas has proved worthwhile in efforts to maximize resection while minimizing risk of iatrogenic damage in patients with brain tumors. Although cortical reorganization has been described, the frequency of its occurrence and the factors that influence incidence are not well understood. The authors investigated changes in language laterality between 2 fMRI studies in patients with brain tumors to elucidate factors contributing to cortical reorganization.
METHODS
The authors analyzed 33 patients with brain tumors involving eloquent language areas who underwent 2 separate presurgical, language task–based fMRI examinations (fMRI1 and fMRI2). Pathology consisted of low-grade glioma (LGG) in 15, and high-grade glioma (HGG) in 18. The mean time interval between scans was 35 ± 38 months (mean ± SD). Regions of interest were drawn for Broca’s area (BA) and the contralateral BA homolog. The laterality index (LI) was calculated and categorized as follows: > 0.2, left dominance; 0.2 to –0.2, codominance; and < −0.2, right dominance. Translocation of language function was defined as a shift across one of these thresholds between the 2 scans. Comparisons between the 2 groups, translocation of language function (reorganized group) versus no translocation (constant group), were performed using the Mann-Whitney U-test.
RESULTS
Nine (27%) of 33 patients demonstrated translocation of language function. Eight of 9 patients with translocation had tumor involvement of BA, compared to 5/24 patients without translocation (p < 0.0001). There was no difference in LI between the 2 groups at fMRI1. However, the reorganized group showed a decreased LI at fMRI2 compared to the constant group (−0.1 vs 0.53, p < 0.01). The reorganized cohort showed a significant difference between LI1 and LI2 (0.50 vs –0.1, p < 0.0001) whereas the constant cohort did not. A longer time interval was found in the reorganized group between fMRI1 and fMRI2 for patients with LGG (34 vs 107 months, p < 0.002). Additionally, the reorganized cohort had a greater proportion of local tumor invasion into eloquent areas at fMRI2 than the constant group. Aphasia was present following fMRI2 in 13/24 (54%) patients who did not exhibit translocation, compared to 2/9 (22%) patients who showed translocation.
CONCLUSIONS
Translocation of language function in patients with brain tumor is associated with tumor involvement of BA, longer time intervals between scans, and is seen in both LGG and HGG. The reduced incidence of aphasia in the reorganized group raises the possibility that reorganization supports the conservation of language function. Therefore, longitudinal fMRI is useful because it may point to reorganization and could affect therapeutic planning for patients.
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Affiliation(s)
- Addison Quinones
- Departments of Radiology,
- Icahn School of Medicine at Mount Sinai, New York, New York
| | | | - Luca Pasquini
- Departments of Radiology,
- Neuroradiology Unit, NESMOS Department, Sant’Andrea Hospital, La Sapienza University, Rome, Italy
| | | | - Nelson S. Moss
- Neurosurgery, Memorial Sloan Kettering Cancer Center, New York
| | - Cameron Brennan
- Neurosurgery, Memorial Sloan Kettering Cancer Center, New York
| | - Viviane Tabar
- Neurosurgery, Memorial Sloan Kettering Cancer Center, New York
| | - Andrei Holodny
- Departments of Radiology,
- Department of Neuroscience, Weill Cornell Graduate School of the Medical Sciences, New York; and
- Department of Radiology, Joan & Sanford I. Weill Medical College of Cornell University, New York, New York
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Hemispheric Asymmetry of the Hand Motor Representations in Patients with Highly Malignant Brain Tumors: Implications for Surgery and Clinical Practice. Brain Sci 2022; 12:brainsci12101274. [PMID: 36291208 PMCID: PMC9599694 DOI: 10.3390/brainsci12101274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 09/19/2022] [Accepted: 09/20/2022] [Indexed: 12/02/2022] Open
Abstract
We addressed both brain pre-surgical functional and neurophysiological aspects of the hand representation in 18 right-handed patients harboring a highly malignant brain tumor in the sensorimotor (SM) cortex (10 in the left hemisphere, LH, and 8 in the right hemisphere, RH) and 10 healthy controls, who performed an fMRI hand-clenching task with both hands alternatively. We extracted the main ROI in the SM cortex and compared ROI values and volumes between hemispheres and groups, in addition to their motor neurophysiological measures. Hemispheric asymmetry in the fMRI signal was observed for healthy controls, namely higher signal for the left-hand movements, but not for either patients’ groups. ROI values, although altered in patients vs. controls, did not differ significantly between groups. ROI volumes associated with right-hand movement were lower for both patients’ groups vs. controls, and those associated with left-hand movement were lower in the RH group vs. all groups. These results are relevant to interpret potential preoperative plasticity and make inferences about postoperative plasticity and can be integrated in the surgical planning to increase surgery success and postoperative prognosis and quality of life.
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Holodny AI. Resting-State Functional MRI Changes in Normal Human Aging. Radiology 2022; 304:633-634. [PMID: 35503020 PMCID: PMC9434810 DOI: 10.1148/radiol.220201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 02/10/2022] [Accepted: 02/15/2022] [Indexed: 11/11/2022]
Affiliation(s)
- Andrei I. Holodny
- From the Department of Radiology, Memorial Sloan Kettering Cancer
Center, 1275 York Ave, New York, NY 10065; Department of Radiology, Weill
Medical College of Cornell University, New York, NY; and Department of
Neuroscience, Weill-Cornell Graduate School of the Medical Sciences, New York,
NY
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7
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Inhibitory Effect of miR-339-5p on Glioma through PTP4A1/HMGB1 Pathway. DISEASE MARKERS 2022; 2022:2231195. [PMID: 35872698 PMCID: PMC9307383 DOI: 10.1155/2022/2231195] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 06/12/2022] [Accepted: 06/18/2022] [Indexed: 12/29/2022]
Abstract
Objective Finding miR-339-5p inhibitory functions in glioma through PTP4A1/HMGB1 pathway. Methods From May 2020 to August 2021, 20 glioblastoma and para cancer tissues were chosen for qRT-PCR analysis. The miR-NC, miR-con, miR-339-5PMIMIC, and miR-con + groups were transfected into human glioma U251 cells. The capacity of cell vascular-like structure construction was found by simulating angiogenesis, and the ability of cell movement was examined by cell scratching. The twofold luciferase reporter gene method determined that miR-339-5p targets PTP4A1, and the protein expression levels of PTP4A1 and HMGB1 were examined using Western blot. Results MiR-339-5P expression was substantially lower in cancer samples than noncancer samples (P < 0.05). PTP4A1 expression in cancer samples was higher than in healthy controls (P < 0.05). The miR-339-5p group produced significantly less vascular-like structures than the NC and miR-con groups (P < 0.05). The miR-339-5p group lowered the invasive index and migratory rate of U251 cells (P < 0.05). PTP4A1 inhibited the luciferase activity of the pTP4A1-WT reporter gene (P < 0.05) but not the PTP4A1-MUT (P > 0.05). The miR-339-5p group had lower protein levels of PTP4A1 and HMGB1 than the NC and miR-con groups (P < 0.05). The development of vascular-like structures was substantially more significant in the miR-con +PTP4A1 group than in the miR-con and miR-339-5p +PTP4A1 groups (P < 0.05). In terms of migration and invasion index, there was a substantial difference between the miR-339-5p +PTP4A1 and the miR-con +PTP4A1 groups (P < 0.05). The miR-con +PTP4A1 group had a greater migration rate and invasive index than the miR-con and miR-339-5p +PTP4A1 groups (P < 0.05). Conclusion MiR-339-5P inhibits angiogenic mimicry, migration, and invasion of brain glioma U251 cells by inhibiting the PTP4A1/HMGB1 signal pathway.
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Fang S, Li L, Weng S, Guo Y, Zhong Z, Fan X, Jiang T, Wang Y. Contralesional Sensorimotor Network Participates in Motor Functional Compensation in Glioma Patients. Front Oncol 2022; 12:882313. [PMID: 35530325 PMCID: PMC9072743 DOI: 10.3389/fonc.2022.882313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 03/11/2022] [Indexed: 11/18/2022] Open
Abstract
Background Some gliomas in sensorimotor areas induce motor deficits, while some do not. Cortical destruction and reorganization contribute to this phenomenon, but detailed reasons remain unclear. This study investigated the differences of the functional connectivity and topological properties in the contralesional sensorimotor network (cSMN) between patients with motor deficit and those with normal motor function. Methods We retrospectively reviewed 65 patients (32 men) between 2017 and 2020. The patients were divided into four groups based on tumor laterality and preoperative motor status (deficit or non-deficit). Thirty-three healthy controls (18 men) were enrolled after matching for sex, age, and educational status. Graph theoretical measurement was applied to reveal alterations of the topological properties of the cSMN by analyzing resting-state functional MRI. Results The results for patients with different hemispheric gliomas were similar. The clustering coefficient, local efficiency, transitivity, and vulnerability of the cSMN significantly increased in the non-deficit group and decreased in the deficit group compared to the healthy group (p < 0.05). Moreover, the nodes of the motor-related thalamus showed a significantly increased nodal efficiency and nodal local efficiency in the non-deficit group and decreased in the deficit group compared with the healthy group (p < 0.05). Conclusions We posited the existence of two stages of alterations of the preoperative motor status. In the compensatory stage, the cSMN sacrificed stability to acquire high efficiency and to compensate for impaired motor function. With the glioma growing and the motor function being totally damaged, the cSMN returned to a stable state and maintained healthy hemispheric motor function, but with low efficiency.
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Affiliation(s)
- Shengyu Fang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
| | - Lianwang Li
- Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
| | - Shimeng Weng
- Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
| | - Yuhao Guo
- Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
| | - Zhang Zhong
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xing Fan
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- *Correspondence: Xing Fan, ; Tao Jiang, ; Yinyan Wang,
| | - Tao Jiang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
- Research Unit of Accurate Diagnosis, Treatment and Translational Medicine of Brain Tumors, Chinese Academy of Medical Sciences, Beijing, China
- *Correspondence: Xing Fan, ; Tao Jiang, ; Yinyan Wang,
| | - Yinyan Wang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
- *Correspondence: Xing Fan, ; Tao Jiang, ; Yinyan Wang,
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9
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What Can Resting-State fMRI Data Analysis Explain about the Functional Brain Connectivity in Glioma Patients? Tomography 2022; 8:267-280. [PMID: 35202187 PMCID: PMC8878995 DOI: 10.3390/tomography8010021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 01/12/2022] [Accepted: 01/14/2022] [Indexed: 11/24/2022] Open
Abstract
Resting-state functional MRI has been increasingly implemented in imaging protocols for the study of functional connectivity in glioma patients as a sequence able to capture the activity of brain networks and to investigate their properties without requiring the patients’ cooperation. The present review aims at describing the most recent results obtained through the analysis of resting-state fMRI data in different contexts of interest for brain gliomas: the identification and localization of functional networks, the characterization of altered functional connectivity, and the evaluation of functional plasticity in relation to the resection of the glioma. An analysis of the literature showed that significant and promising results could be achieved through this technique in all the aspects under investigation. Nevertheless, there is room for improvement, especially in terms of stability and generalizability of the outcomes. Further research should be conducted on homogeneous samples of glioma patients and at fixed time points to reduce the considerable variability in the results obtained across and within studies. Future works should also aim at establishing robust metrics for the assessment of the disruption of functional connectivity and its recovery at the single-subject level.
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Maniar YM, Peck KK, Jenabi M, Gene M, Holodny AI. Functional MRI Shows Altered Deactivation and a Corresponding Decrease in Functional Connectivity of the Default Mode Network in Patients with Gliomas. AJNR Am J Neuroradiol 2021; 42:1505-1512. [PMID: 33985945 DOI: 10.3174/ajnr.a7138] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 02/19/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND PURPOSE The default mode network normally decreases in activity during externally directed tasks. Although default mode network connectivity is disrupted in numerous brain pathologies, default mode network deactivation has not been studied in patients with brain tumors. We investigated default mode network deactivation with language task-based fMRI by measuring the anticorrelation of a critical default mode network node, the posterior cingulate cortex, in patients with gliomas and controls; furthermore, we examined default mode network functional connectivity in these patients with task-based and resting-state fMRI. MATERIALS AND METHODS In 10 healthy controls and 30 patients with gliomas, the posterior cingulate cortex was identified on task-based fMRI and was used as an ROI to create connectivity maps from task-based and resting-state fMRI data. We compared the average correlation in each default mode network region between patients and controls for each correlation map and stratified patients by tumor location, hemisphere, and grade. RESULTS Patients with gliomas (P = .001) and, in particular, patients with tumors near the posterior default mode network (P < .001) showed less posterior cingulate cortex anticorrelation in task-based fMRI than controls. Patients with both left- and right-hemisphere tumors, as well as those with grade IV tumors, showed significantly lower posterior cingulate cortex anticorrelation than controls (P = .02, .03, and <.001, respectively). Functional connectivity in each default mode network region was not significantly different between task-based and resting-state maps. CONCLUSIONS Task-based fMRI showed impaired deactivation of the default mode network in patients with gliomas. The functional connectivity of the default mode network in both task-based and resting-state fMRI in patients with gliomas using the posterior cingulate cortex identified in task-based fMRI as an ROI for seed-based correlation analysis has strong overlap.
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Affiliation(s)
- Y M Maniar
- From the Department of Radiology (Y.M.M., K.K.P., M.J., M.G., A.I.H.), Memorial Sloan Kettering Cancer Center, New York, New York
| | - K K Peck
- From the Department of Radiology (Y.M.M., K.K.P., M.J., M.G., A.I.H.), Memorial Sloan Kettering Cancer Center, New York, New York
- Department of Medical Physics (K.K.P.), Memorial Sloan Kettering Cancer Center, New York, New York
| | - M Jenabi
- From the Department of Radiology (Y.M.M., K.K.P., M.J., M.G., A.I.H.), Memorial Sloan Kettering Cancer Center, New York, New York
| | - M Gene
- From the Department of Radiology (Y.M.M., K.K.P., M.J., M.G., A.I.H.), Memorial Sloan Kettering Cancer Center, New York, New York
| | - A I Holodny
- From the Department of Radiology (Y.M.M., K.K.P., M.J., M.G., A.I.H.), Memorial Sloan Kettering Cancer Center, New York, New York
- Department of Radiology (A.I.H.), Weill Medical College of Cornell University, New York, New York
- Department of Neuroscience (A.I.H.), Weill-Cornell Graduate School of the Medical Sciences, New York, New York
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11
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Yang J, Gohel S, Zhang Z, Hatzoglou V, Holodny AI, Vachha BA. Glioma-Induced Disruption of Resting-State Functional Connectivity and Amplitude of Low-Frequency Fluctuations in the Salience Network. AJNR Am J Neuroradiol 2021; 42:551-558. [PMID: 33384293 DOI: 10.3174/ajnr.a6929] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 10/02/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND AND PURPOSE Cognitive challenges are prevalent in survivors of glioma, but their neurobiology is incompletely understood. The purpose of this study was to investigate the effect of glioma presence and tumor characteristics on resting-state functional connectivity and amplitude of low-frequency fluctuations of the salience network, a key neural network associated with cognition. MATERIALS AND METHODS Sixty-nine patients with glioma (mean age, 48.74 [SD, 14.32] years) who underwent resting-state fMRI were compared with 31 healthy controls (mean age, 49.68 [SD, 15.54] years). We identified 4 salience network ROIs: left/right dorsal anterior cingulate cortex and left/right anterior insula. Average salience network resting-state functional connectivity and amplitude of low-frequency fluctuations within the 4 salience network ROIs were computed. RESULTS Patients with gliomas showed decreased overall salience network resting-state functional connectivity (P = .001) and increased amplitude of low-frequency fluctuations in all salience network ROIs (P < .01) except in the left dorsal anterior cingulate cortex. Compared with controls, patients with left-sided gliomas showed increased amplitude of low-frequency fluctuations in the right dorsal anterior cingulate cortex (P = .002) and right anterior insula (P < .001), and patients with right-sided gliomas showed increased amplitude of low-frequency fluctuations in the left anterior insula (P = .002). Anterior tumors were associated with decreased salience network resting-state functional connectivity (P < .001) and increased amplitude of low-frequency fluctuations in the right anterior insula, left anterior insula, and right dorsal anterior cingulate cortex. Patients with high-grade gliomas had decreased salience network resting-state functional connectivity compared with healthy controls (P < .05). The right anterior insula showed increased amplitude of low-frequency fluctuations in patients with grade II and IV gliomas compared with controls (P < .01). CONCLUSIONS By demonstrating decreased resting-state functional connectivity and an increased amplitude of low-frequency fluctuations related to the salience network in patients with glioma, this study adds to our understanding of the neurobiology underpinning observable cognitive deficits in these patients. In addition to more conventional functional connectivity, amplitude of low-frequency fluctuations is a promising functional-imaging biomarker of tumor-induced vascular and neural pathology.
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Affiliation(s)
- J Yang
- From the Departments of Radiology (J.Y., V.H., A.I.H., B.A.V.)
- New York University Grossman School of Medicine (J.Y.), New York University, New York, New York
| | - S Gohel
- Department of Health Informatics (S.G.), Rutgers University School of Health Professions, Newark, New Jersey
| | - Z Zhang
- Epidemiology and Biostatistics (Z.Z.)
| | - V Hatzoglou
- From the Departments of Radiology (J.Y., V.H., A.I.H., B.A.V.)
- Brain Tumor Center (V.H., A.I.H., B.A.V.), Memorial Sloan Kettering Cancer Center, New York, New York
- Department of Radiology (V.H., A.I.H., B.A.V.), Weill Medical College of Cornell University, New York, New York
| | - A I Holodny
- From the Departments of Radiology (J.Y., V.H., A.I.H., B.A.V.)
- Brain Tumor Center (V.H., A.I.H., B.A.V.), Memorial Sloan Kettering Cancer Center, New York, New York
- Department of Radiology (V.H., A.I.H., B.A.V.), Weill Medical College of Cornell University, New York, New York
- Department of Neuroscience (A.I.H.), Weill-Cornell Graduate School of the Medical Sciences, New York, New York
| | - B A Vachha
- From the Departments of Radiology (J.Y., V.H., A.I.H., B.A.V.)
- Brain Tumor Center (V.H., A.I.H., B.A.V.), Memorial Sloan Kettering Cancer Center, New York, New York
- Department of Radiology (V.H., A.I.H., B.A.V.), Weill Medical College of Cornell University, New York, New York
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12
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Jalilianhasanpour R, Ryan D, Agarwal S, Beheshtian E, Gujar SK, Pillai JJ, Sair HI. Dynamic Brain Connectivity in Resting State Functional MR Imaging. Neuroimaging Clin N Am 2020; 31:81-92. [PMID: 33220830 DOI: 10.1016/j.nic.2020.09.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Dynamic functional connectivity adds another dimension to resting-state functional MR imaging analysis. In recent years, dynamic functional connectivity has been increasingly used in resting-state functional MR imaging, and several studies have demonstrated that dynamic functional connectivity patterns correlate with different physiologic and pathologic brain states. In fact, evidence suggests that dynamic functional connectivity is a more sensitive marker than static functional connectivity; therefore, it might be a promising tool to add to clinical functional neuroimaging. This article provides a broad overview of dynamic functional connectivity and reviews its general principles, techniques, and potential clinical applications.
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Affiliation(s)
- Rozita Jalilianhasanpour
- Division of Neuroradiology, The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 600 North Wolfe Street, Baltimore, MD 21287, USA
| | - Daniel Ryan
- Division of Neuroradiology, The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 600 North Wolfe Street, Baltimore, MD 21287, USA
| | - Shruti Agarwal
- Division of Neuroradiology, The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 600 North Wolfe Street, Baltimore, MD 21287, USA
| | - Elham Beheshtian
- Division of Neuroradiology, The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 600 North Wolfe Street, Baltimore, MD 21287, USA
| | - Sachin K Gujar
- Division of Neuroradiology, The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 600 North Wolfe Street, Baltimore, MD 21287, USA
| | - Jay J Pillai
- Division of Neuroradiology, The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 600 North Wolfe Street, Baltimore, MD 21287, USA; Department of Neurosurgery, Johns Hopkins University School of Medicine, 1800 Orleans Street, Baltimore, MD 21287, USA
| | - Haris I Sair
- Division of Neuroradiology, The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 600 North Wolfe Street, Baltimore, MD 21287, USA; The Malone Center for Engineering in Healthcare, The Whiting School of Engineering, Johns Hopkins University, Baltimore, MD, USA.
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13
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Abstract
There are many technical and nontechnical steps involved in a successful clinical functional MRI (fMRI) scan. The output from scanning and analysis can only be as good as the input, so task instruction and rehearsal are the most important steps during an clinical fMRI procedure. Properly pre-processed data significantly affects statistical analysis, which has a great impact on image interpretation. Even though there is general agreement on how to process clinical fMRI data, such as algorithms for head motion detection and correction, the theory and practicalities associated with data processing remain complex and constantly evolving.
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14
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Abstract
Neurovascular uncoupling (NVU) is one of the most important confounds of blood oxygen level dependent (BOLD) functional magnetic resonance imaging (fMR imaging) in the setting of focal brain lesions such as brain tumors. This article reviews the assessment of NVU related to focal brain lesions with emphasis on the use of cerebrovascular reactivity mapping measurement methods and resting state BOLD fMR imaging metrics in the detection of NVU, as well as the use of amplitude of low-frequency fluctuation metrics to mitigate the effects of NVU on clinical fMR imaging activation.
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Affiliation(s)
- Shruti Agarwal
- Division of Neuroradiology, The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 600 North Wolfe Street, Baltimore, MD 21287, USA
| | - Haris I Sair
- Division of Neuroradiology, The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 600 North Wolfe Street, Baltimore, MD 21287, USA; The Malone Center for Engineering in Healthcare, The Whiting School of Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - Jay J Pillai
- Division of Neuroradiology, The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 600 North Wolfe Street, Baltimore, MD 21287, USA; Department of Neurosurgery, Johns Hopkins University School of Medicine, 1800 Orleans Street, Baltimore, MD 21287, USA.
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Abstract
During the past decade, functional MR imaging has rapidly moved from the research environment into clinical practice. Preoperative functional MR imaging is now standard clinical practice not only in major academic institutions, but also in community neurosurgical and neuroradiologic practices. The clinical use of functional MR imaging will only increase in the years to come. Application of functional MR imaging (including resting-state functional MR imaging) to the context of neuropsychiatric diseases is likely to continue to advance.
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16
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Jütten K, Mainz V, Delev D, Gauggel S, Binkofski F, Wiesmann M, Clusmann H, Na CH. Asymmetric tumor-related alterations of network-specific intrinsic functional connectivity in glioma patients. Hum Brain Mapp 2020; 41:4549-4561. [PMID: 32716597 PMCID: PMC7555062 DOI: 10.1002/hbm.25140] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 06/05/2020] [Accepted: 07/09/2020] [Indexed: 12/12/2022] Open
Abstract
Resting-state functional MRI (rs-fMRI) allows mapping temporally coherent brain networks, and intra- and inter-network alterations have been described in different diseases. This prospective study investigated hemispheric resting-state functional connectivity (RSFC) differences in the default-mode network (DMN) and fronto-parietal network (FPN) between patients with left- and right-hemispheric gliomas (LH PAT, RH PAT), addressing asymmetry effects the tumor might have on network-specific intrinsic functional connectivity under consideration of the prognostically relevant isocitrate-dehydrogenase (IDH) mutation status. Twenty-seven patients (16 LH PAT, 12 IDH-wildtype) and 27 healthy controls underwent anatomical and rs-fMRI as well as neuropsychological assessment. Independent component analyses were performed to identify the DMN and FPN. Hemispheric DMN- and FPN-RSFC were computed, compared across groups, and correlated with cognitive performance. Patient groups did not differ in tumor volume, grade or location. RH PAT showed higher contra-tumoral DMN-RSFC than controls and LH PAT. With regard to the FPN, contra-tumoral RSFC was increased in both patient groups as compared to controls. Higher contra-tumoral RSFC was associated with worse cognitive performance in patients, which, however, seemed to apply mainly to IDH-wildtype patients. The benefit of RSFC alterations for cognitive performance varied depending on the affected hemisphere, cognitive demand, and seemed to be altered by IDH-mutation status. At the time of study initiation, a clinical trial registration was not mandatory at our faculty, but it can be applied for if requested.
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Affiliation(s)
- Kerstin Jütten
- Department of Neurosurgery, RWTH Aachen University, Aachen, Germany
| | - Verena Mainz
- Institute of Medical Psychology and Medical Sociology, RWTH Aachen University, Aachen, Germany
| | - Daniel Delev
- Department of Neurosurgery, RWTH Aachen University, Aachen, Germany
| | - Siegfried Gauggel
- Institute of Medical Psychology and Medical Sociology, RWTH Aachen University, Aachen, Germany
| | - Ferdinand Binkofski
- Division of Clinical Cognitive Sciences, RWTH Aachen University, Aachen, Germany
| | - Martin Wiesmann
- Department of Diagnostic and Interventional Neuroradiology, RWTH Aachen University, Aachen, Germany
| | - Hans Clusmann
- Department of Neurosurgery, RWTH Aachen University, Aachen, Germany
| | - Chuh-Hyoun Na
- Department of Neurosurgery, RWTH Aachen University, Aachen, Germany
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