Functional MRI vs. navigated TMS to optimize M1 seed volume delineation for DTI tractography. A prospective study in patients with brain tumours adjacent to the corticospinal tract
| Autor: | Karl-Josef Langen, Gabriele Stoffels, Carolin Weiss Lucas, Andrea Faymonville, Irada Tursunova, Charlotte Nettekoven, Volker Neuschmelting, Christian Grefkes, Hannah Lockau, Ana-Maria Oros-Peusquens, Shah N. Jon, Roland Goldbrunner |
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| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Male
PLIC Posterior limb of the internal capsule Internal capsule medicine.medical_treatment Pyramidal Tracts RMT Resting motor threshold SE Standard error lcsh:RC346-429 030218 nuclear medicine & medical imaging MEP Motor-evoked potential nTMS 0302 clinical medicine FWE Family-wise error SD Standard deviation Brain Mapping medicine.diagnostic_test Brain Neoplasms DCS Direct cortical stimulation fMRI Motor Cortex ROI Regular Article Anatomy Middle Aged Magnetic Resonance Imaging Transcranial Magnetic Stimulation medicine.anatomical_structure Diffusion Tensor Imaging Neurology FOV Field-of-view OR Odd's ratio Anatomical relationship MPRAGE Magnetization prepared rapid acquisition gradient echo (T1 MR seq.) lcsh:R858-859.7 Female FA(T) Fractional anisotropy (threshold) BOLD Blood-oxygenation-level dependent Psychology pxsq p-value according to Pearson's chi-square test Tractography Adult CST Corticospinal tract M1 Primary motor cortex ROI Region-of-interest Cognitive Neuroscience DTI Diffusion tensor imaging lcsh:Computer applications to medicine. Medical informatics MFL Minimal fibre length dMRI Diffusion magnetic resonance imaging (i.e. diffusion-weighted imaging DWI) 03 medical and health sciences fMRI Functional magnetic resonance imaging EF Electric field medicine Humans Radiology Nuclear Medicine and imaging EMG Electromyography KPS Karnofsky performance scale X-sq X-squared (Pearson's chi-square test) ddc:610 FACT Fibre assignment by continuous tracking lcsh:Neurology. Diseases of the nervous system Aged CST Pyramidal tracts Somatotopic nTMS Neuronavigated transcranial magnetic stimulation Pons Transcranial magnetic stimulation LT Lateral tongue muscle anterior third nervous system PM Plantar muscle Corticospinal tract Pyramidal tract Neurology (clinical) Functional magnetic resonance imaging Neuroscience 030217 neurology & neurosurgery APB Abductor pollicis brevis muscle Deterministic |
| Zdroj: | NeuroImage: Clinical 13, 297-309 (2017). doi:10.1016/j.nicl.2016.11.022 NeuroImage : Clinical NeuroImage: Clinical, Vol 13, Iss C, Pp 297-309 (2017) |
| DOI: | 10.1016/j.nicl.2016.11.022 |
| Popis: | Background DTI-based tractography is an increasingly important tool for planning brain surgery in patients suffering from brain tumours. However, there is an ongoing debate which tracking approaches yield the most valid results. Especially the use of functional localizer data such as navigated transcranial magnetic stimulation (nTMS) or functional magnetic resonance imaging (fMRI) seem to improve fibre tracking data in conditions where anatomical landmarks are less informative due to tumour-induced distortions of the gyral anatomy. We here compared which of the two localizer techniques yields more plausible results with respect to mapping different functional portions of the corticospinal tract (CST) in brain tumour patients. Methods The CSTs of 18 patients with intracranial tumours in the vicinity of the primary motor area (M1) were investigated by means of deterministic DTI. The core zone of the tumour-adjacent hand, foot and/or tongue M1 representation served as cortical regions of interest (ROIs). M1 core zones were defined by both the nTMS hot-spots and the fMRI local activation maxima. In addition, for all patients, a subcortical ROI at the level of the inferior anterior pons was implemented into the tracking algorithm in order to improve the anatomical specificity of CST reconstructions. As intra-individual control, we additionally tracked the CST of the hand motor region of the unaffected, i.e., non-lesional hemisphere, again comparing fMRI and nTMS M1 seeds. The plausibility of the fMRI-ROI- vs. nTMS-ROI-based fibre trajectories was assessed by a-priori defined anatomical criteria. Moreover, the anatomical relationship of different fibre courses was compared regarding their distribution in the anterior-posterior direction as well as their location within the posterior limb of the internal capsule (PLIC). Results Overall, higher plausibility rates were observed for the use of nTMS- as compared to fMRI-defined cortical ROIs (p Highlights • Somatotopic DTI-tractography in 18 patients with motor-eloquent brain tumours • Comparing functional MRI versus navigated TMS for localization of seeding region • Use of nTMS yield more plausible CST tractographies in close tumour vicinity. • More rostral course of TMS-originated fibres as compared to functional MRI |
| Databáze: | OpenAIRE |
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