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National Center for Image Guided Therapy

Functional MRI for Neurosurgical Planning

Automated classification of fMRI data employing trial-based imagery tasks: The exclusively task-specific ROIs obtained from the two sessions (1st and 2nd) for five subjects (S1-S5; the p-value was different depending on the outcome of optimization. The six mental tasks (with corresponding acronyms) were (1) right-hand motor imagery (RH), (2) left-hand motor imagery (LH), (3) right foot motor imagery (RF), (4) mental calculation (MC), (5) internal speech generation (IS), and (6) visual imagery (VI).

To advance surgical planning, the Neurosurgery Core of the NCIGT along with its fellow Cores is investigating and refining preoperative fMRI and diffusion tensor imaging (DTI) - two methods of analyzing MRI images to reveal aspects about the functional activity of the brain through blood perfusion and about its anatomical complexity based on an understanding of tissue with respect to water diffusion. Because they use MR images, fMRI and DTI are non-invasive methods of mapping eloquent cortical areas and critical white matter structures that can be used to assess these areas in relationship to a tumor or other pathological neural manifestations. Such functional and anatomical information is crucial to understanding an individual's brain to best plan for surgery, especially when the activity of the brain is shifting over time if areas have become compromised. To optimize surgical planning and performance, a neurosurgical team needs as much functional and anatomical information on an individual patient's brain as possible to understand its unique aspects and configurations.

The NCIGT continues to add to the collective knowledge base of what is understood about the functional activities and characteristics of the brain through fMRI. A focus of NCIGT researchers is applying software techniques to fMRI data and comparing data from normal subjects to those with brain tumors or epilepsy to pinpoint language function to improve surgical planning.

Neurosurgical researchers are working on a study of overt language function through multimodal functional mappings using fMRI, MEG, and DTI across the same subjects. This effort will result in comprehensive mappings useful for the image guided surgical resection of lesions near critical language centers of the brain. To date, researchers have designed and tested fMRI protocols for a comparative study of music and language dissociations in the temporal lobe. fMRI findings, combined with intraoperative data collected by our collaborators from BWH, evidenced a singing and speech network that is separately distributed in the right and left temporal lobes, respectively. Such understandings will be useful in therapies aimed at helping otherwise aphasic patients to use singing as a form of overt communication.

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