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Presurgical motor, somatosensory and language fMRI: Technical feasibility and limitations in 491 patients over 13 years

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Abstract

Objectives

To analyse the long-term feasibility and limitations of presurgical fMRI in a cohort of tumour and epilepsy patients with different MR-scanners at 1.5 and 3.0 T.

Methods

Four hundred and ninety-one consecutive patients undergoing presurgical fMRI between 2000 and 2012 on five different MR-scanners using established paradigms and semi-automated data processing were included. Success rates of task performance and BOLD-activation were determined for motor and somatosensory somatotopic mapping and language localisation. Procedural success, failures and imaging artifacts were analysed. MR-field strengths were compared.

Results

Two thousand three hundred fifteen of 2348 (98.6 %) attempted paradigms (1033 motor, 1220 speech, 95 somatosensory) were successfully performed. 100 paradigms (4.3 %) were repetition runs. 23 speech, 6 motor and 2 sensory paradigms failed for non-compliance and technical issues. Most language paradigm failures were noted in overt sentence generation. Average significant BOLD-activation was higher for motor than language paradigms (95.8 vs. 81.6 %). Most language paradigms showed significantly higher activation rates at 3 T compared to 1.5 T, whereas no significant difference was found for motor paradigms.

Conclusions

fMRI proved very robust for the presurgical localisation of the different motor and somatosensory body representations, as well as Broca’s and Wernicke’s language areas across different MR-scanners at 1.5 and 3.0 T over 13 years.

Key Points

• Standardised presurgical motor and language fMRI is robust across various MRI platforms.

• Motor fMRI is less dependent on field strength than language fMRI.

• fMRI task failures are relatively low and are reduced by paradigm repetition.

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Acknowledgments

The scientific guarantor of this publication is Dr. Anthony Tyndall and Prof. Christoph Stippich.

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. No complex statistical methods were necessary for this paper. Institutional Review Board approval was obtained for all patients studied. Written informed consent was waived by the Institutional Review Board.

Some study subjects or cohorts have been previously reported, but only in other scientific context/research questions (publications listed below)

Primary motor cortex activation and lateralization in patients with tumours of the central region.

Tozakidou M, Wenz H, Reinhardt J, Nennig E, Riffel K, Blatow M, Stippich C. Neuroimage Clin. 2013 Jan 14;2:221–8.

Clinical standardized fMRI reveals altered language lateralization in patients with brain tumour. Partovi S, Jacobi B, Rapps N, Zipp L, Karimi S, Rengier F, Lyo JK, Stippich C. AJNR Am J Neuroradiol. 2012 Dec;33(11):2151–7.

Diagnostic benefits of presurgical fMRI in patients with brain tumours in the primary sensorimotor cortex. Wengenroth M, Blatow M, Guenther J, Akbar M, Tronnier VM, Stippich C. Eur Radiol. 2011 Jul;21(7):1517–25.

Localizing and lateralizing language in patients with brain tumours: feasibility of routine preoperative functional MR imaging in 81 consecutive patients. Stippich C, Rapps N, Dreyhaupt J, Durst A, Kress B, Nennig E, Tronnier VM, Sartor K. Radiology. 2007 Jun;243(3):828–36.

Methodology: retrospective, observational, multicentre study.

Author information

Authors and Affiliations

  1. Division of Diagnostic and Interventional Neuroradiology, University Hospital Basel, Basel, Switzerland

    Anthony J. Tyndall, Julia Reinhardt & Christoph Stippich

  2. Department of Neurosurgery, University Hospital Schleswig-Holstein, Luebeck Campus, Luebeck, Germany

    Volker Tronnier

  3. Department of Neurosurgery, University Hospitals Basel, Basel, Switzerland

    Luigi Mariani

Authors
  1. Anthony J. Tyndall
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  2. Julia Reinhardt
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  3. Volker Tronnier
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  4. Luigi Mariani
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  5. Christoph Stippich
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Corresponding author

Correspondence to Christoph Stippich.

Appendix

Appendix

Table 3 fMRI measurement techniques and MRI parameters
Full size table

Legend 1(Table 1) : TR values: italic: speech/normal: motor & sensory; FOV = field of view; RF = radio frequency; MPRAGE = Magnetization-Prepared Rapid-Acquisition-Gradient-Echo sequence;

Functional MRI block designs:

Speech (Locally established covert and overt word and generation; overall n = 307 patients and modified Aachen Aphasia Sentence Generation; n = 7 patients). Standardized asymmetric block design: 4 × 36 s task alternating with 5 × 18 s periods of rest [8].

Total: 234 seconds

Speech (US-based; n = 10 patients). Standardized block design: 6 × 20 s rest alternating with 6 × 20 s periods of task [17]

Total: 240 seconds

Motor (hand, foot and tongue; overall n = 268 patients). Standardized asymmetric block design: 3 × 20 s task alternating with 4 × 20 s periods of rest [10]

Total: 140 seconds

Sensory (hand and foot; n = 31 patients): Standardized asymmetric block design: 3 × 15 s task alternating with 4 × 15 s periods of rest [6]

Total: 105 seconds

Legend 2: Block design representations of fMRI paradigms: light grey = period of rest; dark grey = task (values given in seconds). Total time is given per paradigm.

MRI Scanners and Paradigms over study period

figure a

Legend 3: Appendix Table/Figure depicting the number of patients with motor, speech and somatosensory fMRI mapping per MRI scanner used over a period of 12 years (Picker Edge 1.5 T [2000–2004]; Siemens Symphony 1.5 T [2003–2007]; Siemens Avanto 1.5 T [2009–2012]; Siemens Trio 1.5 T [2005–2009]; Siemens Verio [2009–2012]; dark grey shading = 3 T; MRI site 1 = University Hospital of Heidelberg, Germany; MRI site 2 = University Hospital of Basel, Switzerland).

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Tyndall, A.J., Reinhardt, J., Tronnier, V. et al. Presurgical motor, somatosensory and language fMRI: Technical feasibility and limitations in 491 patients over 13 years. Eur Radiol 27, 267–278 (2017). https://doi.org/10.1007/s00330-016-4369-4

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