title: Characterizing the relationship between functional MRI-derived measures and clinical outcomes in patients with vascular lesions.
abstract: OBJECTIVE
  Functional MRI (fMRI) has proven to be an effective component of pretreatment planning in patients harboring a variety of different brain lesions. The authors have recently reported significant relationships concerning distances between brain tumor borders and areas of functional activation (lesion-to-activation distance; LAD) with regard to patient morbidity and mortality. This study further examines the relationship between LAD, focusing on a host of vascular lesions and pre- and posttreatment morbidity.
  
  
  METHODS
  This study included a sample population of patients with vascular lesions (n = 106), primarily arteriovenous malformations (AVMs) and cavernomas. These patients underwent pretreatment fMRI-based motor mapping (n = 72) or language mapping (n = 84). The impact of LAD and other variables derived from the patient medical record were analyzed with respect to functional deficits in terms of morbidity (weakness and/or aphasia).
  
  
  RESULTS
  In patients with no pretreatment deficits, there was trend for a significant relationship between the Wernicke area LAD and posttreatment language deficits. In patients with or without pretreatment deficits, a trend toward significance was observed between sensorimotor LAD and posttreatment motor deficits. Additionally, lesion type (AVMs or cavernomas) affected posttreatment deficits, with more patients with cavernomas showing posttreatment language deficits than patients with AVMs. However, this difference was not observed for posttreatment motor deficits.
  
  
  CONCLUSIONS
  These findings suggest that the proximity of a vascular lesion to sensorimotor and language areas is a relevant parameter in estimating patient prognosis in the perioperative period. Additionally, vascular lesion type and existence of pretreatment deficits play a significant role in outcomes.
authors.affiliation: Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Gallagher
authors.affiliation: Department of Radiology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA.
authors.forename: Veena A
authors.initials: VA
authors.lastname: Nair
authors.affiliation: Department of Radiology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA.
authors.forename: Michael F
authors.initials: MF
authors.lastname: Regner
authors.affiliation: Department of Radiology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA.
authors.forename: Brittany M
authors.initials: BM
authors.lastname: Young
authors.affiliation: Department of Radiology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA.
authors.forename: Andrew
authors.initials: A
authors.lastname: Radtke
authors.affiliation: Department of Radiology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA.
authors.forename: Joshua
authors.initials: J
authors.lastname: Pankratz
authors.affiliation: Department of Radiology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA.
authors.forename: Ryan L
authors.initials: RL
authors.lastname: Holdsworth
authors.affiliation: Department of Radiology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA.
authors.forename: Dovile
authors.initials: D
authors.lastname: Baniulis
authors.affiliation: Department of Radiology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA.
authors.forename: Nicole K
authors.initials: NK
authors.lastname: Kornder
authors.affiliation: Department of Radiology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA.
authors.forename: Jed
authors.initials: J
authors.lastname: Voss
authors.affiliation: Cardiovascular Research Center, University of Wisconsin-Madison, Madison, Wisconsin, USA.
authors.forename: Benjamin P
authors.initials: BP
authors.lastname: Austin
authors.affiliation: Department of Radiology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA.
authors.forename: Chad
authors.initials: C
authors.lastname: Moritz
authors.affiliation: Department of Medical Physics, University of Wisconsin-Madison, Madison, Wisconsin, USA.
authors.forename: Elizabeth M
authors.initials: EM
authors.lastname: Meyerand
authors.affiliation: Department of Radiology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA.
authors.forename: Vivek
authors.initials: V
authors.lastname: Prabhakaran
mesh_terms: D000328:Adult; D005260:Female; D005625:Frontal Lobe / Q000502:physiology*; D006392:Hemangioma, Cavernous / Q000175:diagnosis* / Q000453:epidemiology / Q000601:surgery; D006801:Humans; D002538:Intracranial Arteriovenous Malformations / Q000175:diagnosis* / Q000453:epidemiology / Q000601:surgery; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control; D012189:Retrospective Studies; D013702:Temporal Lobe / Q000502:physiology*; D016896:Treatment Outcome
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