Multimodal Brain Mapping in Patients with Early Brain Lesions

Abstract

The developing human brain possesses a superior potential of functional reorganization after lesions compared with the adult brain. Because of such reorganizational processes, children with early brain lesions often show abnormally located cortical representations of certain brain functions, e.g. of motor representations (Carr et al., Brain 116:1223–1247, 1993; Staudt et al., Brain 125:2222–2237, 2002; Staudt et al., Ann Neurol 56:854–863, 2004) or of language functions (Rasmussen and Milner, Ann N Y Acad Sci 30:355–369, 1977; Staudt et al., Neuroimage 16:954–967, 2002). Nowadays, these abnormally located representations can be identified non-invasively using techniques such as functional magnetic resonance imaging (MRI) (fMRI), transcranial magnetic stimulation (TMS), or magnetoencephalography (MEG). Thus, these techniques not only can contribute to our general understanding of the processes involved in the reorganization of the developing human brain but can also be used clinically in the pre-surgical evaluation of children who have to undergo brain surgery, e.g. for the relief of pharmaco-refractory epilepsies originating from their lesions (Hertz-Pannier et al., Childs Nerv Syst 17:223–228, 2001; Staudt et al., Neuropediatrics 32:159–161, 2001; Staudt et al., Ann Neurol 56:854–863, 2004; Staudt et al., J Neurosurg 101:69–77, 2004; Liégeois et al., J Magn Reson Imaging 23:933–940, 2006).