Functional Connectivity of Intrinsic Brain Activity for Presurgical Mapping

描述（由申请人提供）：癫痫患者生存和提高生活质量的最大希望是尽可能多地切除引起癫痫发作的病变，同时尽可能多地保留正常的大脑功能。目前，癫痫患者的手术前测绘需要多层次的方法，包括几种不同的程序和测试。由于无法跟随任务，许多幼儿不能进行手术前测绘，并且经常需要麻醉进行核磁共振成像。我们希望开发一种神经成像方法，可以在几乎任何病人身上进行，在大约10分钟内绘制所有相关的雄辩皮层，包括运动系统、语言系统和记忆系统，而不需要病人积极参与。我们假设使用功能连接磁共振成像（fcMRI）可以基于内在功能连接准确地绘制皮层的基本区域。在休息时，甚至在麻醉状态下，病人的依从性将不被要求，一个单一的，简单的程序可以用于特定神经系统的功能映射。这项技术可以为那些可能难以跟随英语指示的患者绘制语言、记忆和运动系统的地图，比如儿童、发育障碍患者，甚至是无意识的人。这种类型的神经成像可能会导致一种新的语言和记忆侧化技术，并且在传统的侵入性Wada测试和侵入性脑成像无法实现时可能有用。在这里，我们提出了一项计划，在健康受试者中发展这项技术，然后在接受手术纠正癫痫的患者中验证它。该项目提出了一种新的方法，为癫痫患者的术前绘图，如果成功，将允许术前功能神经成像的患者谁目前无法进行功能绘图。

DESCRIPTION (provided by applicant): The best hope for survival and improved quality of life in patients with epilepsy is to remove of as much of the lesion causing seizures as possible, while preserving as much normal functioning brain as possible. Currently, presurgical mapping of patients with epilepsy requires a multi-layered approach that involves several different procedures and tests. Many young children cannot have presurgical mapping due to the inability to follow tasks and often need anesthesia for a MRI. We hope to develop a neuroimaging method that can be performed in virtually any patient that maps all relevant eloquent cortex-including the motor system, language systems, and memory systems-in about 10 minutes, and without the need of patient active participation. We hypothesize that essential areas of cortex can be accurately mapped based on intrinsic functional connectivity using functional connectivity magnetic resonance imaging (fcMRI). While at rest, and even under anestheisa, patient compliance will not be required and a single, simple procedure could be used for functional mapping of specific neural systems. This technique makes it possible to map language, memory, and motor systems in patients who might have difficulty following English directions, such as children, the developmentally impaired, and even people who are unconscious. This type of neuroimaging may lead to a new language and memory lateralization technique, and might be useful when the traditional invasive Wada test and invasive brain mapping are not possible. Here, we propose a plan to develop the technique in healthy subjects and then validate it in patients who undergo surgery to correct their epilepsy. This project proposes a new approach for presurgical mapping for epilepsy patients that, if successful, would allow presurgical functional neuroimaging in patients who currently are unable to have functional mapping.