Functional Connectivity of Intrinsic Brain Activity for Presurgical Mapping

描述（由申请人提供）：癫痫患者生存和改善生活质量的最大希望是尽可能多地切除导致癫痫发作的病变，同时尽可能多地保留正常功能的大脑。 目前，癫痫患者的术前映射需要一种涉及几种不同程序和测试的多层方法。 许多幼儿由于无法完成任务而无法进行术前标测，并且通常需要麻醉进行MRI。 我们希望开发一种神经成像方法，几乎可以在任何患者身上进行，在大约10分钟内映射所有相关的功能皮层，包括运动系统，语言系统和记忆系统，而不需要患者积极参与。 我们假设，皮质的基本领域可以准确地映射基于内在的功能连接使用功能连接磁共振成像（fcMRI）。 在休息时，甚至在麻醉状态下，不需要病人的依从性，一个简单的程序可以用于特定神经系统的功能映射。 这项技术可以映射语言，记忆和运动系统的患者可能有困难的英语方向，如儿童，发育障碍，甚至是无意识的人。 这种类型的神经影像学可能会导致一种新的语言和记忆偏侧化技术，并可能是有用的，当传统的侵入性瓦达测试和侵入性脑映射是不可能的。 在这里，我们提出了一个计划，在健康受试者中开发该技术，然后在接受手术以纠正癫痫的患者中验证它。 该项目提出了一种新的癫痫患者术前映射方法，如果成功，将允许目前无法进行功能映射的患者进行术前功能神经成像。 公共卫生相关性：癫痫影响了美国约150万人。 该项目的目标是使用一种新的成像方法来定位癫痫发作起源的大脑部位。 此外，用同样的测试，确定语言，记忆和运动功能在大脑中的位置。 该测试将在美国广泛使用的标准磁共振成像扫描仪（MRI）上进行。 经过10分钟的扫描，它将为神经外科医生提供完整的大脑地图，用于癫痫的手术治疗。

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. PUBLIC HEALTH RELEVANCE: Epilepsy affects about 1.5 million people in the United States. The goal of this project is to use a new method of imaging to locate the site in the brain where the seizures originate. Further, with the same test, determine where language, memory and motor function are in the brain. This test will be performed on a standard magnetic resonance imaging scanner (MRI) that is widely available in the United State. After a ten minute scan, it will give a neurosurgeon the complete map of the brain for surgical treatment of epilepsy.