Pre-surgical Language Mapping with fMRI using a Natural Viewing Condition

描述（由申请人提供）：病变靠近重要功能区域（感觉、运动或语言）的患者在计划或实施手术治疗时提出了特殊的挑战。因此，了解个体结构-功能组织及其与病变的关系对手术计划至关重要。目前功能磁共振成像（fMRI）已成为最广泛采用的非侵入性方法来识别个体功能解剖，以指导神经外科决策。传统的功能磁共振成像（fMRI）用于绘制语言功能需要患者执行精确的定时和认知控制的语言任务。由于语言功能的组织结构复杂多变，迄今为止，对于能够可靠、完整地识别语言敏感区域的最佳任务范式还没有达成共识。此外，为了提高fMRI的预测价值，患者通常会接受一组任务，这些任务对他们来说可能很难理解和执行。该项目旨在开发一种新的功能磁共振成像模式，通过使用自然观看条件，患者只需要观看娱乐电影片段，就可以有效地映射个体的语言功能。最近的研究发现，初级感觉-运动和关联区域对自然刺激的反应是可靠的和选择性的，该假设是，当人们观看由时变语言内容（对话、配音、场景设置）组成的同一电影片段时，功能性语言区域的时间反应在个体之间也是高度同步的。通过检测哪些大脑区域表达类似的时间反应，甚至可以在神经外科患者中检测到潜在扭曲或重组的语言区域。我们将从健康受试者和在语言皮层或附近有病变的脑肿瘤患者中获取观看电影和基于任务的语言功能核磁共振成像。该项目的目标是：(1)研究健康受试者语言区域的BOLD反应，提取可靠且同步的时间剖面，构建语言反应模型；(2)通过比较不同的语言反应模型分析方法来制定分析策略；(3)通过与基于任务的功能磁共振成像（fMRI）进行比较，评估其有效性。并验证对脑肿瘤患者进行侵入性语言映射的黄金标准。与基于任务的fMRI相比，这种要求较低的模式将更容易让患者执行（特别是那些已经存在神经缺陷的患者），更容易让技术人员管理，

DESCRIPTION (provided by applicant): Patients with lesions near important functional regions (sensory, motor, or language) pose a particular challenge when planning or executing surgical treatment. Thus, understanding of the individual structural-functional organization and the relationship to the lesion is crucial for surgical planning. Currently functional magnetic resonance imaging (fMRI) has become the most broadly adopted non-invasive method to identify individual functional anatomy to guide neurosurgical decision- making. Conventional fMRI for mapping language function requires that the patient perform precisely timed and cognitively controlled language tasks. Due to the complex and variable organization of language function, to date, there is no consensus on optimal task paradigms that can reliably and completely identify language-sensitive regions. In addition, to improve the predictive value of fMRI, patients usually undergo a panel of tasks, which can be difficult for them to understand and perform. This project aims to develop a novel fMRI paradigm that can effectively map individuals' language function by using a natural viewing condition, where patients only need to watch an entertaining movie clip. Based on recent studies which have found reliable and selective responses in primary sensory-motor and association areas with naturalistic stimuli, the hypothesis is that the temporal responses within functional language areas are also highly synchronized across individuals when they watch the same movie clip consisting of time-varying linguistic content (dialogue, voice over, scene setting), and by detecting which brain areas express similar temporal responses even potentially distorted or reorganized language areas can be detected in neurosurgical patients. We will acquire movie-watching and task-based language fMRIs from healthy subjects and brain tumor patients with lesions in or near language cortex. The objectives of this project are: (1) To investigate BOLD responses from putative language areas of healthy subjects, and extract reliable and synchronized temporal profiles to build language response model, (2) To develop an analysis strategy by comparing different analytic approaches for detecting language areas in individual subjects using the language response model, and (3) To evaluate the effectiveness by comparing with task-based fMRI, and validating against gold-standard invasive language mapping in brain tumor patients. Compared with task-based fMRI, this less-demanding paradigm will be easier for patients to perform (especially those with pre-existing neurological deficits), easier for technologists to administer, and more time- and cost-effective by studying natural language function with only one simple fMRI acquisition. Exploration of this novel paradigm requires development and testing of sophisticated signal processing techniques which will be developed under this proposal. PUBLIC HEALTH RELEVANCE: Our goal is to develop an improved method to map critical language areas using functional Magnetic Resonance Imaging (fMRI) to help neurosurgeons perform more effective and safer surgeries for patients with brain tumors. To overcome some of the difficulties associated with current practice, in which the patient needs to perform many repetitions of complex language tasks, we propose a "natural viewing" condition in which the patient only needs to watch a movie clip while in the MRI scanner. This method is easier for patients to undergo and for technologists to administer, could reduce the time and cost, and most importantly is more suited for a wide range of patient populations, including those who cannot perform language tasks due to cognitive deficits.