title: Use of functional MRI to guide decisions in a clinical stroke trial.
abstract: OBJECTIVE
  An investigational trial examined safety and efficacy of targeted subthreshold cortical stimulation in patients with chronic stroke. The anatomical location for the target, hand motor area, varies across subjects, and so was localized with functional MRI (fMRI). This report describes the experience of incorporating standardized fMRI into a multisite stroke trial.
  
  
  METHODS
  At 3 enrollment centers, patients moved (0.25 Hz) the affected hand during fMRI. Hand motor function was localized at a fourth center guiding intervention for those randomized to stimulation.
  
  
  RESULTS
  The fMRI results were available within 24 hours. Across 12 patients, activation site variability was substantial (12, 23, and 11 mm in x, y, and z directions), exceeding stimulating electrode dimensions.
  
  
  CONCLUSIONS
  Use of fMRI to guide decision-making in a clinical stroke trial is feasible.
authors.affiliation: University of California, Irvine, Calif , USA. scramer@uci.edu
authors.forename: Steven C
authors.initials: SC
authors.lastname: Cramer
authors.forename: Randall R
authors.initials: RR
authors.lastname: Benson
authors.forename: David M
authors.initials: DM
authors.lastname: Himes
authors.forename: Vijaya C
authors.initials: VC
authors.lastname: Burra
authors.forename: Jeri S
authors.initials: JS
authors.lastname: Janowsky
authors.forename: Martin E
authors.initials: ME
authors.lastname: Weinand
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Brown
authors.forename: Helmi L
authors.initials: HL
authors.lastname: Lutsep
mesh_terms: D000328:Adult; D000368:Aged; D002908:Chronic Disease; D046690:Deep Brain Stimulation; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D009044:Motor Cortex / Q000473:pathology / Q000503:physiopathology; D020521:Stroke / Q000175:diagnosis*