Neuroanatomical Considerations in Preoperative Functional Brain Mapping

David Black, Jason T. Little, Derek R. Johnson

Research output: Contribution to journalReview article

3 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)213-224
Number of pages12
JournalTopics in Magnetic Resonance Imaging
Volume28
Issue number4
DOIs
StatePublished - Aug 1 2019

Keywords

  • Broca
  • dorsolateral prefrontal cortex
  • Exner
  • functional MRI
  • Geschwind
  • neuroanatomy
  • Wernicke

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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