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

描述(由申请人提供)：在计划或执行手术治疗时，靠近重要功能区(感觉、运动或语言)的患者构成了一个特殊的挑战。因此，了解个体的结构-功能组织及其与病变的关系对于手术计划至关重要。目前，功能磁共振成像(FMRI)已成为目前应用最广泛的非侵入性方法，用于识别个体功能解剖结构以指导神经外科决策。传统的功能磁共振成像语言功能图需要患者执行精确的时间和认知控制的语言任务。由于语言功能的组织复杂多变，到目前为止，对于能够可靠地、完全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，为了提高功能磁共振成像的预测价值，患者通常会经历一系列任务，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范式，通过使用自然观看条件来有效地映射个人的语言功能，患者只需观看有趣的电影剪辑。基于最近的研究发现，在初级感觉-运动区域和与自然刺激相关的区域中，可靠的和选择性的反应是，当人们观看由时变语言内容(对话、画外音、场景设置)组成的同一电影片段时，功能性语言区域内的时间反应在个体之间也是高度同步的，并通过检测大脑中哪些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的扭曲或重组的语言区域。我们将从健康受试者和语言皮质受损或邻近的脑肿瘤患者那里获得看电影和基于任务的语言磁共振成像。本项目的目标是：(1)调查健康受试者假设的语言区域的大胆反应，并提取可靠和同步的时间轮廓来建立语言反应模型；(2)通过比较不同的分析方法来检测单个受试者的语言区域，从而制定分析策略；(3)通过与基于任务的功能磁共振成像(FMRI)的比较，以及与脑肿瘤患者金标准侵入性语言测绘的对比，来评估其有效性。与基于任务的功能磁共振相比，这种要求较低的范例对患者(特别是那些先前存在神经缺陷的患者)更容易执行，技术人员更容易管理， 而且只需一次简单的fMRI采集就可以学习自然语言功能，从而更省时、更具成本效益。探索这一新的范例需要开发和测试复杂的信号处理技术，这些技术将根据这一提议进行开发。

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.