title: Resting functional connectivity in patients with brain tumors in eloquent areas.
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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Neurological Surgery, Hospital Universitario Marqués de Valdecilla, Instituto de Formación e Investigación Marqués de Valdecilla, Santander, Cantabria, Spain.
authors.forename: Juan
authors.initials: J
authors.lastname: Martino
authors.forename: Susanne M
authors.initials: SM
authors.lastname: Honma
authors.forename: Anne M
authors.initials: AM
authors.lastname: Findlay
authors.forename: Adrian G
authors.initials: AG
authors.lastname: Guggisberg
authors.forename: Julia P
authors.initials: JP
authors.lastname: Owen
authors.forename: Heidi E
authors.initials: HE
authors.lastname: Kirsch
authors.forename: Mitchel S
authors.initials: MS
authors.lastname: Berger
authors.forename: Srikantan S
authors.initials: SS
authors.lastname: Nagarajan
mesh_terms: D000328:Adult; D000368:Aged; D001931:Brain Mapping; D001932:Brain Neoplasms / Q000473:pathology / Q000503:physiopathology*; D002540:Cerebral Cortex / Q000473:pathology / Q000503:physiopathology*; D004558:Electric Stimulation; D005260:Female; D005910:Glioma / Q000473:pathology / Q000503:physiopathology*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D015225:Magnetoencephalography; D008297:Male; D008875:Middle Aged; D009415:Nerve Net / Q000473:pathology / Q000503:physiopathology*; D057234:Preoperative Period; D018709:Statistics, Nonparametric