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AJNR Am J Neuroradiol. 2018 Aug;39(8):1493-1498. doi: 10.3174/ajnr.A5709. Epub 2018 Jul 12.

Preoperative Mapping of the Supplementary Motor Area in Patients with Brain Tumor Using Resting-State fMRI with Seed-Based Analysis.

Author information

1
From the Russell H. Morgan Department of Radiology and Radiological Sciences (J.W., A.E.T., S.A., S.K.G., J.J.P., H.I.S.).
2
Department of Radiology (J.W.), Siriraj Hospital, Mahidol University, Bangkok, Thailand.
3
Department of Computer Science and Department of Electrical and Computer Engineering (A.C.), Johns Hopkins University, Baltimore, Maryland.
4
Department of Neurosurgery (J.J.P.), Johns Hopkins University School of Medicine, Baltimore, Maryland.
5
From the Russell H. Morgan Department of Radiology and Radiological Sciences (J.W., A.E.T., S.A., S.K.G., J.J.P., H.I.S.) hsair1@jhmi.edu.

Abstract

BACKGROUND AND PURPOSE:

The supplementary motor area can be a critical region in the preoperative planning of patients undergoing brain tumor resection because it plays a role in both language and motor function. While primary motor regions have been successfully identified using resting-state fMRI, there is variability in the literature regarding the identification of the supplementary motor area for preoperative planning. The purpose of our study was to compare resting-state fMRI to task-based fMRI for localization of the supplementary motor area in a large cohort of patients with brain tumors presenting for preoperative brain mapping.

MATERIALS AND METHODS:

Sixty-six patients with brain tumors were evaluated with resting-state fMRI using seed-based analysis of hand and orofacial motor regions. Rates of supplementary motor area localization were compared with those in healthy controls and with localization results by task-based fMRI.

RESULTS:

Localization of the supplementary motor area using hand motor seed regions was more effective than seeding using orofacial motor regions for both patients with brain tumor (95.5% versus 34.8%, P < .001) and controls (95.2% versus 45.2%, P < .001). Bilateral hand motor seeding was superior to unilateral hand motor seeding in patients with brain tumor for either side (95.5% versus 75.8%/75.8% for right/left, P < .001). No difference was found in the ability to identify the supplementary motor area between patients with brain tumors and controls.

CONCLUSIONS:

In addition to task-based fMRI, seed-based analysis of resting-state fMRI represents an equally effective method for supplementary motor area localization in patients with brain tumors, with the best results obtained with bilateral hand motor region seeding.

PMID:
30002054
DOI:
10.3174/ajnr.A5709

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