Resting-state fMRI for Language Mapping in Brain Tumor Patients

 描述（由申请人提供）：包括功能性磁共振成像（fMRI）在内的脑映射的进展增加了我们对功能性脑组织的理解。特别是相关的临床应用，功能磁共振成像已被证明是一个有用的和有效的方法映射个人的大脑功能，并越来越多地被采用作为术前工具，以指导神经外科决策。功能磁共振成像现在带有一个临床计费代码，反映了它在最大限度地减少使用更具侵入性的脑映射技术，如用于语言偏侧化的颈动脉内杏仁核测试（Wada测试）和用于定位关键脑区域的术中皮层电刺激（ECS）方面的效用。传统的功能磁共振成像要求受试者执行感兴趣的行为任务，并使用任务时间和信号变化之间的相关性来展示参与执行该任务的大脑区域。最近的研究已经调查了大脑区域的“功能连接”，作为对大脑区域进行功能分类的方法，即使在休息状态下也是如此。使用在休息时获得的fMRI数据可以提供许多优势，如果它被发现是有效和可靠的。基于任务的功能磁共振成像需要一个专家神经心理学家来管理和评分的行为范式相比，静息态功能磁共振成像可以获得更广泛的专业人士，从而使其更广泛和成本效益。静息状态功能磁共振成像不需要积极的主体参与，因此可能特别适合于可能有神经功能缺损的患者。调查接受脑损伤神经外科手术的患者的功能连接也可以提供对伴随脑损伤和恢复的脑功能组织变化的见解。在奖励期间，研究小组将获得15名接受神经外科评估和治疗的脑肿瘤患者的静息状态和基于任务的语言功能磁共振成像。我们将开发功能连接MRI方法，以映射个体受试者水平的语言功能。拟议的实验将评估重测信度和效度的静息态功能磁共振成像语言映射对临床神标准技术在个别患者。我们的假设是，静息态功能磁共振成像是可靠的语言映射，并与基于任务的语言功能磁共振成像，Wada和ECS测试。我们的目标是改善脑肿瘤手术的功能磁共振成像语言映射，并创建一个易于管理的测试，可以帮助标准化各机构的功能磁共振成像研究。这个探索性的项目将产生有价值的初步数据，为更大的多中心验证静息状态功能磁共振成像在图像引导脑肿瘤手术。

 DESCRIPTION (provided by applicant): Advances in brain mapping including functional magnetic resonance imaging (fMRI) have increased our understanding of functional brain organization. Particularly relevant for clinical applications, fMRI has proven a useful and valid method for mapping of individual brain function and is increasingly being adopted as a pre-surgical tool to guide neurosurgical decision-making. fMRI now carries a clinical billing code reflecting its utility in minimizing the use of more invasive brain mapping techniques such as the intracarotid amytal test (Wada test) for language lateralization and intra- operative electrocortical stimulation (ECS) for localization of critical brain regions. Traditional fMRI requires that the subject perform a behavioral task of interest and uses correlations between task timing and signal changes to demonstrate brain areas involved in the performance of that task. Recent studies have investigated "functional connectivity" of brain regions as a method to functionally categorize brain regions, even during resting states. The use of fMRI data acquired during rest could offer numerous advantages if it is found to be valid and reliable. Compared to task-based fMRI that requires an expert neuropsychologist to administer and score the behavioral paradigm, resting-state fMRI could be acquired by a greater range of professionals thereby making it more broadly available and cost-effective. Resting-state fMRI does not require active subject participation and may thus be particularly well-suited to patients who may have neurological deficits. Investigating functional connectivity in patients undergoing neurosurgery for brain lesions may also provide insights into the changes in brain functional organization that accompany brain injury and recovery. During the award period the research team will acquire resting-state and task-based language fMRI in 15 brain tumors patients undergoing neurosurgical evaluation and treatment. We will develop functional connectivity MRI approaches to map language function at the individual subject level. The proposed experiments will evaluate test-retest reliability and validity of resting-state fMRI for language mapping against clinical god-standard techniques in individual patients. Our hypothesis is that resting-state fMRI is reliable for language mapping, and in agreement with task-based language fMRI, Wada and ECS testing. Our goal is to improve fMRI language mapping for brain tumor surgery, and to create an easily administered test which could help standardize fMRI studies across institutions. This exploratory project will generate valuable preliminary data for larger multi-center validation of resting- state fMRI in image-guide brain tumor surgery.