Combination of magnetoencephalography (MEG) and functional magnetic resonance imaging (FMRI) for neurosurgical mapping of the sensory and motor cortices

N. Nakasato, T. Inoue, A. Takahashi, A. Kanno, K. Hatanaka, H. Shimizu, T. Kumabe, T. Yoshimoto
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Abstract

Magnetoencephalography (MEG) and functional magnetic resonance imaging (FMRI) were applied to brain mapping in normal volunteers and three patients with tumors. Somatosensory evoked fields (SEFs) due to median, ulnar and posterior tibial nerve stimulation were measured using a whole head MEG system. FMRI used an echo planner imaging method during hand, toe and lip movement. Estimated SEF dipoles and activated FMRI regions were superimposed on anatomical MRI. The central sulcus was identified by source localization of the SEFs in all subjects. Functional abnormality could be detected as reduced amplitude or latency delay of the SEF peaks. FMRI indicated multiple and extended regions of activation, such as primary motor, primary sensory and supplementary motor cortices. The highest signal activation was usually found in the contralateral primary sensory/motor cortices. However, the primary motor and sensory cortices were not activated due the effect of the lesion in one patient. The highest activation was found far posterior to the central sulcus due to a large venous inflow effect in another patient. The combination of MEG and FMRI can avoid any misinterpretation due to use of only one method of functional brain mapping, especially in patients with brain lesions.
结合脑磁图(MEG)和功能磁共振成像(FMRI)用于感觉和运动皮层的神经外科制图
应用脑磁图(MEG)和功能磁共振成像(FMRI)对正常志愿者和3例肿瘤患者进行脑成像。采用全头部脑磁图系统测量正中神经、尺神经和胫后神经刺激引起的体感诱发场(SEFs)。FMRI在手、脚趾和嘴唇运动时使用回声规划成像方法。在解剖MRI上叠加估计的SEF偶极子和激活的FMRI区域。所有受试者的中心沟都是通过sef的来源定位来确定的。功能异常表现为SEF峰幅值降低或延迟。FMRI显示多个和扩展的激活区域,如初级运动皮质,初级感觉皮质和辅助运动皮质。最高的信号激活通常发现在对侧初级感觉/运动皮层。然而,由于病变的影响,一名患者的初级运动和感觉皮层未被激活。在另一名患者中,由于大量静脉流入效应,在中央沟的后方发现了最高的激活。MEG和FMRI的结合可以避免由于仅使用一种脑功能制图方法而产生的任何误解,特别是在脑病变患者中。
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