title: Resting-State Blood Oxygen Level-Dependent Functional MRI: A Paradigm Shift in Preoperative Brain Mapping.
abstract: Currently, functional magnetic resonance imaging (fMRI) facilitates a preoperative awareness of an association of an eloquent region with a tumor. This information gives the neurosurgeon helpful information that can aid in creating a surgical strategy. Typically, task-based fMRI has been employed to preoperatively localize speech and motor function. Task-based fMRI depends on the patient's ability to comply with the task paradigm, which often is impaired in the setting of a brain tumor. This problem is overcome by using resting-state fMRI (rs-fMRI) to localize function. rs-fMRI measures spontaneous fluctuations in the blood oxygen level-dependent (BOLD) signal, representing the brain's functional organization. In a neurosurgical context, it allows noninvasive simultaneous assessment of multiple large-scale distributed networks. Compared with task-related fMRI, rs-fMRI provides more comprehensive information on the functional architecture of the brain and is applicable in settings where task-related fMRI may provide inadequate information or could not be performed. Taken together, rs-fMRI substantially expands the preoperative mapping capability in efficiency, effectiveness, and scope. In this article, a brief introduction into rs-fMRI processing methods is followed by a detailed discussion on the role rs-fMRI plays in presurgical planning.
authors.affiliation: Washington University School of Medicine, Saint Louis, Mo., USA.
authors.forename: Eric C
authors.initials: EC
authors.lastname: Leuthardt
authors.forename: Monica
authors.initials: M
authors.lastname: Allen
authors.forename: Mudassar
authors.initials: M
authors.lastname: Kamran
authors.forename: Ammar H
authors.initials: AH
authors.lastname: Hawasli
authors.forename: Abraham Z
authors.initials: AZ
authors.lastname: Snyder
authors.forename: Carl D
authors.initials: CD
authors.lastname: Hacker
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Mitchell
authors.forename: Joshua S
authors.initials: JS
authors.lastname: Shimony
mesh_terms: D001931:Brain Mapping / Q000379:methods*; D006801:Humans; D008279:Magnetic Resonance Imaging; D011300:Preoperative Care