Tecniche di esecuzione della RMf per l'individuazione delle aree cerebrali eloquenti ed applicazione alla neurochirurgia

Translated title of the contribution: Functional magnetic resonance imaging to disclose eloquent brain areas and its neurosurgical applications

F. Signorelli, J. Guyotat, M. Principi, S. Paolini, I. Aprile

Research output: Contribution to journalArticle

Abstract

Functional magnetic resonance imaging (fMR) measures changes in cerebral blood flow and hence offers indirect information on local neuronal activity. This technique will identify the cortical and subcortical brain areas involved in activities like movement, general and specific sensitivity, language and memory. fMR is therefore a key investigation in exploring cognitive processes and brain functions in healthy subjects and in patients with central nervous system diseases. fMR is applied in the treatment of brain diseases in eloquent cerebral areas, providing pre-operative detection of such areas in relation to a brain lesion or epileptogenic focus. This allows the brain lesion to resected as radically as possible, sparing the functional areas identified and thereby improving the patient's survival rate and quality of life. In addition, by providing information on the pathogenetic mechanism of neurogenic pain and certain movement disorders like Parkinson's disease, fMR is gaining importance in the treatment of these diseases. Most fMR teams use 1.5 Tesla systems and the most widely used sequences are eco-planar scans exploiting the "BOLD" (blood-oxygen-level-dependent) effect. For reliable results, acquisition and image processing protocols must be strict. The different paradigms used to identify the various functional areas share the alternation of activation and rest phases. Punctual effective activation paradigms will establish significant differences in neuronal excitation between the two phases and accurate statistical analysis of the images obtained yield reliable results. Lastly, the statistical map of activations displayed in different colours depending on degree of significance is superimposed on "anatomical" images, usually sagittal and axial T1-weighted scans, to allow a better localisation of activation areas. Despite recent major technical advances which in many cases have confirmed the results of pre-operative mapping by fMR with invasive eletrcophysiological monitoring techniques (intra-operative evoked potentials and cortical stimulation), the reliability of fMR findings still depends on both rigorous examination performance and image processing as well as other factors whose impact is more difficult to gauge. Further progress in image analysis methods and the adoption of standard protocols by different teams will allow a comparison of the outcome of activations, making fMR more reliable and suitable for more widescale application. This will bring major advantages in the treatment of lesions in eloquent brain areas and shed light on still unknown pathophysiological mechanisms responsible for disease.

Original languageItalian
Pages (from-to)389-394
Number of pages6
JournalRivista di Neuroradiologia
Volume14
Issue number4
Publication statusPublished - 2001

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Magnetic Resonance Imaging
Brain
Cerebrovascular Circulation
Central Nervous System Diseases
Movement Disorders
Brain Diseases
Evoked Potentials
Parkinson Disease
Healthy Volunteers
Language
Therapeutics
Survival Rate
Color
Quality of Life
Oxygen
Pain

ASJC Scopus subject areas

  • Clinical Neurology
  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

Cite this

Tecniche di esecuzione della RMf per l'individuazione delle aree cerebrali eloquenti ed applicazione alla neurochirurgia. / Signorelli, F.; Guyotat, J.; Principi, M.; Paolini, S.; Aprile, I.

In: Rivista di Neuroradiologia, Vol. 14, No. 4, 2001, p. 389-394.

Research output: Contribution to journalArticle

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