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Functional MRI

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MRI in Epilepsy

Part of the book series: Medical Radiology ((Med Radiol Diagn Imaging))

Abstract

Functional magnetic resonance imaging (fMRI) is an abundantly applied tool for the preoperative localization and/or lateralization of brain functions. It is noninvasive and therefore apparently without risk for patients. However, the particular risk of fMRI lies in several methodological limitations which can give rise to misinterpretations. These can result in fatal surgical decisions, for example, the resection of undetected functional cortex or the unnecessary sparing of tissue which has to be removed to achieve freedom from seizures. This chapter explains the methodological aspects of fMRI with special focus on its limitations, but also gives recommendations for safe clinical application of fMRI.

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References

  • Adcock JE, Wise RG, Oxbury JM, Oxbury SM, Matthews PM (2003) Quantitative fMRI assessment of the differences in lateralization of language-related brain activation in patients with temporal lobe epilepsy. Neuroimage 18(2):423–438

    Article  PubMed  CAS  Google Scholar 

  • Baxendale S (2009) The Wada test. Curr Opin Neurol 22(2):185–189.

    Article  PubMed  Google Scholar 

  • Berger MS, Kincaid J, Ojemann GA, Lettich E (1989) Brain mapping techniques to maximize resection, safety, and seizure control in children with brain tumors. Neurosurgery 25(5):786–792

    Article  PubMed  CAS  Google Scholar 

  • Binder JR, Swanson SJ, Hammeke TA, Morris GL, Mueller WM, Fischer M, Benbadis S, Frost JA, Rao SM, Haughton VM (1996) Determination of language dominance using functional MRI: a comparison with the Wada test. Neurology 46(4):978–984

    Article  PubMed  CAS  Google Scholar 

  • Binder JR, Frost JA, Hammeke TA, Bellgowan PS, Rao SM, Cox RW (1999) Conceptual processing during the conscious resting state. A functional MRI study. J Cogn Neurosci 11(1):80–95

    Article  PubMed  CAS  Google Scholar 

  • Bonelli SB, Powell RH, Yogarajah M, Samson RS, Symms MR, Thompson PJ, Koepp MJ, Duncan JS (2010) Imaging memory in temporal lobe epilepsy: predicting the effects of temporal lobe resection. Brain 133(Pt 4):1186–1199

    Article  PubMed  Google Scholar 

  • Desmond JE, Annabel Chen SH (2002) Ethical issues in the clinical application of fMRI: factors affecting the validity and interpretation of activations. Brain Cogn 50(3):482–497

    Article  PubMed  Google Scholar 

  • Donaldson DI, Buckner RL (2001) Effective paradigm design. In: Mathews PM, Jezzard P, Evans AC (Eds.) Functional magnetic resonance imaging of the brain: methods for neuroscience. Oxford University Press, Oxford 177–195

    Google Scholar 

  • Fernandez G, de Greiff A, von Oertzen J, Reuber M, Lun S, Klaver P, Ruhlmann J, Reul J, Elger CE (2001) Language mapping in less than 15 min: real-time functional MRI during routine clinical investigation. Neuroimage 14(3):585–594

    Article  PubMed  CAS  Google Scholar 

  • FitzGerald DB, Cosgrove GR, Ronner S, Jiang H, Buchbinder BR, Belliveau JW, Rosen BR, Benson RR (1997) Location of language in the cortex: a comparison between functional MR imaging and electrocortical stimulation. AJNR Am J Neuroradiol 18(8):1529–1539

    PubMed  CAS  Google Scholar 

  • Golby AJ, Poldrack RA, Brewer JB, Spencer D, Desmond JE, Aron AP, Gabrieli JD (2001) Material-specific lateralization in the medial temporal lobe and prefrontal cortex during memory encoding. Brain 124(Pt 9):1841–1854

    Article  PubMed  CAS  Google Scholar 

  • Haag A, Knake S, Hamer HM, Boesebeck F, Freitag H, Schulz R, Baum P, Helmstaedter C, Wellmer J, Urbach H, Hopp P, Mayer T, Hufnagel A, Jokeit H, Lerche H, Uttner I, Meencke HJ, Meierkord H, Pauli E, Runge U, Saar J, Trinka E, Benke T, Vulliemoz S, Wiegand G, Stephani U, Wieser HG, Rating D, Werhahn K, Noachtar S, Schulze-Bonhage A, Wagner K, Alpherts WC, Boas WE, Rosenow F (2008) The Wada test in Austrian, Dutch, German, and Swiss epilepsy centers from 2000 to 2005: a review of 1421 procedures. Epilepsy Behav 13(1):83–89

    Article  PubMed  CAS  Google Scholar 

  • Hamberger MJ (2007) Cortical language mapping in epilepsy: a critical review. Neuropsychol Rev 17(4):477–489

    Article  PubMed  Google Scholar 

  • Helmstaedter C, Kurthen M, Linke DB, Elger CE (1997) Patterns of language dominance in focal left and right hemisphere epilepsies: relation to MRI findings, EEG, sex, and age at onset of epilepsy. Brain Cogn 33(2):135–150

    Article  PubMed  CAS  Google Scholar 

  • Helmstaedter C, Brosch T, Kurthen M, Elger CE (2004) The impact of sex and language dominance on material-specific memory before and after left temporal lobe surgery. Brain 127(Pt 7):1518–1525

    Article  PubMed  CAS  Google Scholar 

  • Jansen A, Menke R, Sommer J, Forster AF, Bruchmann S, Hempleman J, Weber B, Knecht S (2006) The assessment of hemispheric lateralization in functional MRI—robustness and reproducibility. Neuroimage 33(1):204–217

    Article  PubMed  CAS  Google Scholar 

  • Janszky J, Jokeit H, Heinemann D, Schulz R, Woermann FG, Ebner A (2003) Epileptic activity influences the speech organization in medial temporal lobe epilepsy. Brain 126(Pt 9):2043–2051

    Article  PubMed  CAS  Google Scholar 

  • Kurthen M, Helmstaedter C, Linke DB, Hufnagel A, Elger CE, Schramm J (1994) Quantitative and qualitative evaluation of patterns of cerebral language dominance. An amobarbital study. Brain Lang 46(4):536–564

    Article  PubMed  CAS  Google Scholar 

  • Liegeois F, Connelly A, Cross JH, Boyd SG, Gadian DG, Vargha-Khadem F, Baldeweg T (2004) Language reorganization in children with early-onset lesions of the left hemisphere: an fMRI study. Brain 127(Pt 6):1229–1236

    Article  PubMed  CAS  Google Scholar 

  • Loddenkemper T, Morris HH, Moddel G (2008) Complications during the Wada test. Epilepsy Behav 13(3):551–553

    Article  PubMed  Google Scholar 

  • Logothetis NK (2002) The neural basis of the blood-oxygen-level-dependent functional magnetic resonance imaging signal. Philos Trans R Soc Lond Ser B Biol Sci 357(1424):1003–1037

    Article  Google Scholar 

  • Loring DW, Meador KJ, Allison JD, Pillai JJ, Lavin T, Lee GP, Balan A, Dave V (2002) Now you see it, now you don’t: statistical and methodological considerations in fMRI. Epilepsy Behav 3(6):539–547

    Article  PubMed  Google Scholar 

  • Price CJ (2000) The anatomy of language: contributions from functional neuroimaging. J Anat 197(Pt 3):335–359

    Article  PubMed  Google Scholar 

  • Ramsey NF, Sommer IE, Rutten GJ, Kahn RS (2001) Combined analysis of language tasks in fMRI improves assessment of hemispheric dominance for language functions in individual subjects. Neuroimage 13(4):719–733

    Article  PubMed  CAS  Google Scholar 

  • Ruff IM, Petrovich Brennan NM, Peck KK, Hou BL, Tabar V, Brennan CW, Holodny AI (2008) Assessment of the language laterality index in patients with brain tumor using functional MR imaging: effects of thresholding, task selection, and prior surgery. AJNR Am J Neuroradiol 29(3):528–535

    Article  PubMed  CAS  Google Scholar 

  • Rutten GJ, Ramsey NF, van Rijen PC, van Veelen CW (2002) Reproducibility of fMRI-determined language lateralization in individual subjects. Brain Lang 80(3):421–437

    Article  PubMed  CAS  Google Scholar 

  • Sabbah P, Chassoux F, Leveque C, Landre E, Baudoin-Chial S, Devaux B, Mann M, Godon-Hardy S, Nioche C, Ait-Ameur A, Sarrazin JL, Chodkiewicz JP, Cordoliani YS (2003) Functional MR imaging in assessment of language dominance in epileptic patients. Neuroimage 18(2):460–467

    Article  PubMed  CAS  Google Scholar 

  • Spreer J, Arnold S, Quiske A, Wohlfarth R, Ziyeh S, Altenmuller D, Herpers M, Kassubek J, Klisch J, Steinhoff BJ, Honegger J, Schulze-Bonhage A, Schumacher M (2002) Determination of hemisphere dominance for language: comparison of frontal and temporal fMRI activation with intracarotid amytal testing. Neuroradiology 44(6):467–474

    Article  PubMed  CAS  Google Scholar 

  • Staudt M (2010) Reorganization after pre- and perinatal brain lesions. J Anat 217(4):469–474

    Article  PubMed  Google Scholar 

  • Swanson SJ, Sabsevitz DS, Hammeke TA, Binder JR (2007) Functional magnetic resonance imaging of language in epilepsy. Neuropsychol Rev 17(4):491–504

    Article  PubMed  Google Scholar 

  • Weber B, Wellmer J, Reuber M, Mormann F, Weis S, Urbach H, Ruhlmann J, Elger CE, Fernandez G (2006) Left hippocampal pathology is associated with atypical language lateralization in patients with focal epilepsy. Brain 129(Pt 2):346–351

    PubMed  Google Scholar 

  • Wellmer J, Fernández G, Linke DB, Urbach H, Elger CE, Kurthen M (2005) Unilateral intracarotid amobarbital procedure for language lateralization. Epilepsia 46:1764–1772

    Article  PubMed  Google Scholar 

  • Wellmer J, Weber B, Urbach H, Reul J, Fernandez G, Elger CE (2009) Cerebral lesions can impair fMRI-based language lateralization. Epilepsia 50(10):2213–2224

    Article  PubMed  Google Scholar 

  • Wellmer J, von der Groeben F, Klarmann U, Weber C, Elger CE, Urbach H, Clusmann H, von Lehe M. (2012) Risk-benefit ratio of chronic invasive presurgical evaluation of epilepsy patients using subdural and intracerebral electrodes. Epilepsia 2012 Aug 53(8):1322−1332. doi:10.1111/j.1528-1167.2012.03545.x

  • Wellmer J, Weber B, Weis S, Klaver P, Urbach H, Reul J, Fernandez G, Elger CE (2008) Strongly lateralized activation in language fMRI of atypical dominant patients—implications for presurgical work-up. Epilepsy Res 80:67–76

    Article  PubMed  Google Scholar 

  • Wilke M, Schmithorst VJ (2006) A combined bootstrap/histogram analysis approach for computing a lateralization index from neuroimaging data. Neuroimage 33(2):522–530

    Article  PubMed  Google Scholar 

  • Yetkin FZ, Mueller WM, Morris GL, McAuliffe TL, Ulmer JL, Cox RW, Daniels DL, Haughton VM (1997) Functional MR activation correlated with intraoperative cortical mapping. AJNR Am J Neuroradiol 18(7):1311–1315

    PubMed  CAS  Google Scholar 

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Acknowledgments

I thank S. Bonelli, MD, PhD, for critically reviewing the manuscript.

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Authors and Affiliations

  1. Ruhr-Epileptology, Department of Neurology, University Hospital Knappschaftskrankenhaus, Bochum, Germany

    Jörg Wellmer

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  1. Jörg Wellmer
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Correspondence to Jörg Wellmer .

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Editors and Affiliations

  1. , Radiology/Neuroradiology, University Hospital Bonn, Siegmund Freud-Str. 25, Bonn, 53105, Germany

    Horst Urbach

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© 2013 Springer-Verlag Berlin Heidelberg

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Wellmer, J. (2013). Functional MRI. In: Urbach, H. (eds) MRI in Epilepsy. Medical Radiology(). Springer, Berlin, Heidelberg. https://doi.org/10.1007/174_2012_563

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  • DOI: https://doi.org/10.1007/174_2012_563

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-25137-5

  • Online ISBN: 978-3-642-25138-2

  • eBook Packages: MedicineMedicine (R0)

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