Resting functional connectivity in patients with brain tumors in eloquent areas

Authors

  • Juan Martino MD,

    1. Department of Neurological Surgery, Hospital Universitario Marqués de Valdecilla and Instituto de Formación e Investigación Marqués de Valdecilla (IFIMAV), Santander, Cantabria, Spain
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  • Susanne M. Honma RT,

    1. Biomagnetic Imaging Laboratory, Department of Radiology and Biomedical Imaging, University of California, San Francisco (UCSF), San Francisco, CA
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  • Anne M. Findlay MA,

    1. Biomagnetic Imaging Laboratory, Department of Radiology and Biomedical Imaging, University of California, San Francisco (UCSF), San Francisco, CA
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  • Adrian G. Guggisberg MD,

    1. Division of Neurorehabilitation, Department of Clinical Neurosciences, University Hospital of Geneva, Geneva, Switzerland
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  • Julia P. Owen BS,

    1. Biomagnetic Imaging Laboratory, Department of Radiology and Biomedical Imaging, University of California, San Francisco (UCSF), San Francisco, CA
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  • Heidi E. Kirsch MS, MD,

    1. Biomagnetic Imaging Laboratory, Department of Radiology and Biomedical Imaging, University of California, San Francisco (UCSF), San Francisco, CA
    2. Department of Neurology, University of California, San Francisco (UCSF), San Francisco, CA
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  • Mitchel S. Berger MD,

    1. Department of Neurological Surgery, University of California, San Francisco (UCSF), San Francisco, CA
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  • Srikantan S. Nagarajan PhD

    Corresponding author
    1. Biomagnetic Imaging Laboratory, Department of Radiology and Biomedical Imaging, University of California, San Francisco (UCSF), San Francisco, CA
    • Department of Radiology and Biomedical Imaging, University of California San Francisco (UCSF). 513 Parnassus Avenue, S-362, San Francisco, CA 94143-0628
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Abstract

Objective

Resection of brain tumors adjacent to eloquent areas represents a challenge in neurosurgery. If maximal resection is desired without inducing postoperative neurological deficits, a detailed knowledge of the functional topography in and around the tumor is crucial. The aim of the present work is to evaluate the value of preoperative magnetoencephalography (MEG) imaging of functional connectivity to predict the results of intraoperative electrical stimulation (IES) mapping, the clinical gold standard for neurosurgical localization of functional areas.

Methods

Resting-state whole-cortex MEG recordings were obtained from 57 consecutive subjects with focal brain tumors near or within motor, sensory, or language areas. Neural activity was estimated using adaptive spatial filtering algorithms, and the mean imaginary coherence between the rest of the brain and voxels in and around brain tumors were compared to the mean imaginary coherence between the rest of the brain and contralesional voxels as an index of functional connectivity. IES mapping was performed in all subjects. The cortical connectivity pattern near the tumor was compared to the IES results.

Results

Maps with decreased resting-state functional connectivity in the entire tumor area had a negative predictive value of 100% for absence of eloquent cortex during IES. Maps showing increased resting-state functional connectivity within the tumor area had a positive predictive value of 64% for finding language, motor, or sensory cortical sites during IES mapping.

Interpretation

Preoperative resting state MEG connectivity analysis is a useful noninvasive tool to evaluate the functionality of the tissue surrounding tumors within eloquent areas, and could potentially contribute to surgical planning and patient counseling. Ann Neurol 2011;69:–

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