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Preoperative functional magnetic resonance imaging assessment of higher-order cognitive function in patients undergoing surgery for brain tumors.

Abstract：

OBJECT:Resection of brain tumors has been shown to increase patient survival. The extent of the possible resection, however, depends on whether the tumor has invaded brain regions important for motor, sensory, or cognitive processes and whether the brain tissue surrounding the tumor maintains its functional role. The goal of the present study was to develop new pre- and intraoperative tools to specifically assess the function of the rostral part of the dorsal premotor cortex (PMdr) in 4 patients with brain tumors close to this region. METHODS:Using functional magnetic resonance (fMR) imaging and a task developed to assess accurate selection between competing responses based on conditional rules, the authors preoperatively assessed the function of the PMdr in 4 patients with brain tumors close to this region. In 1 patient, the authors developed an intraoperative procedure to assess performance on the task during the tumor resection. RESULTS:Preoperative fMR imaging data showed specific activity increases in the vicinity of the tumors, that is, in the PMdr. As confirmed by postoperative structural MR imaging, the extent of the tumor resection was optimal and the functional region within the PMdr was preserved. Furthermore, patients exhibited no postoperative deficits during task performance, demonstrating that the function was preserved. Intraoperative behavioral results demonstrated that the cognitive processes underlying performance on the task remained intact throughout the tumor resection. CONCLUSIONS:These findings suggest that preoperative fMR imaging, together with intraoperative behavioral evaluation, may be a useful paradigm to assist neurosurgeons in preserving cognitive function in patients with brain tumors.

journal_name

J Neurosurg

journal_title

Journal of neurosurgery

authors

Amiez C,Kostopoulos P,Champod AS,Collins DL,Doyon J,Del Maestro R,Petrides M

doi

10.3171/JNS/2008/108/2/0258

subject

Has Abstract

pub_date

2008-02-01 00:00:00

pages

258-68

issue

eissn

0022-3085

issn

1933-0693

journal_volume

108

pub_type

杂志文章

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Preoperative functional magnetic resonance imaging assessment of higher-order cognitive function in patients undergoing surgery for brain tumors.