Henry Roland G, Berman Jeffrey I, Nagarajan Srikantan S, Mukherjee Pratik, Berger Mitchel S
Department of Radiology, University of California, San Francisco, San Francisco, CA 94143, USA.
Neuroimage. 2004 Feb;21(2):616-22. doi: 10.1016/j.neuroimage.2003.09.047.
The combination of mapping functional cortical neurons by intraoperative cortical stimulation and axonal architecture by diffusion tensor MRI fiber tracking can be used to delineate the pathways between functional regions. In this study the authors investigated the feasibility of combining these techniques to yield connectivity associated with motor speech and naming. Diffusion tensor MRI fiber tracking provides maps of axonal bundles and was combined with intraoperative mapping of eloquent cortex for a patient undergoing brain tumor surgery. Tracks from eight stimulated sites in the inferior frontal cortex including mouth motor, speech arrest, and anomia were generated from the diffusion tensor MRI data. The regions connected by the fiber tracking were compared to foci from previous functional imaging reports on language tasks. Connections were found between speech arrest, mouth motor, and anomia sites and the SMA proper and cerebral peduncle. The speech arrest and a mouth motor site were also seen to connect to the putamen via the external capsule. This is the first demonstration of delineation of subcortical pathways using diffusion tensor MRI fiber tracking with intraoperative cortical stimulation. The combined techniques may provide improved preservation of eloquent regions during neurological surgery, and may provide access to direct connectivity information between functional regions of the brain.
术中皮层刺激映射功能皮层神经元与扩散张量磁共振成像（MRI）纤维追踪的轴突结构相结合，可用于描绘功能区之间的通路。在本研究中，作者探讨了结合这些技术以产生与运动性言语和命名相关的连接性的可行性。扩散张量MRI纤维追踪提供轴突束图谱，并与一名接受脑肿瘤手术患者的术中明确皮层映射相结合。从扩散张量MRI数据生成了来自额下回八个刺激部位（包括口部运动、言语停顿和命名障碍）的轨迹。将纤维追踪连接的区域与先前关于语言任务的功能成像报告中的病灶进行比较。发现言语停顿、口部运动和命名障碍部位与中央前回固有部和大脑脚之间存在连接。言语停顿部位和一个口部运动部位还通过外囊与壳核相连。这是首次使用扩散张量MRI纤维追踪与术中皮层刺激来描绘皮层下通路。这些联合技术可能会在神经外科手术期间更好地保留明确区域，并可能提供获取大脑功能区之间直接连接信息的途径。
