Rosazza Cristina, Aquino Domenico, D'Incerti Ludovico, Cordella Roberto, Andronache Adrian, Zacà Domenico, Bruzzone Maria Grazia, Tringali Giovanni, Minati Ludovico
Neuroradiology Department, Fondazione IRCCS Istituto Neurologico "Carlo Besta", Milano, Italy; Scientific Department, Fondazione IRCCS Istituto Neurologico "Carlo Besta", Milano, Italy.
Neuroradiology Department, Fondazione IRCCS Istituto Neurologico "Carlo Besta", Milano, Italy.
PLoS One. 2014 Jun 10;9(6):e98860. doi: 10.1371/journal.pone.0098860. eCollection 2014.
Resting state fMRI (rs-fMRI) has recently been considered as a possible complement or alternative to task-based fMRI (tb-fMRI) for presurgical mapping. However, evidence of its usefulness remains scant, because existing studies have investigated relatively small samples and focused primarily on qualitative evaluation. The aim of this study is to investigate the clinical usefulness of rs-fMRI in the context of presurgical mapping of motor functions, and in particular to determine the degree of correspondence with tb-fMRI which, while not a gold-standard, is commonly used in preoperative setting. A group of 13 patients with lesions close to the sensorimotor cortex underwent rs-fMRI and tb-fMRI to localize the hand, foot and mouth motor areas. We assessed quantitatively the degree of correspondence between multiple rs-fMRI analyses (independent-component and seed-based analyses) and tb-fMRI, with reference to sensitivity and specificity of rs-fMRI with respect to tb-fMRI, and centre-of-mass distances. Agreement with electro-cortical stimulation (ECS) was also investigated, and a traditional map thresholding approach based on agreement between two experienced operators was compared to an automatic threshold determination method. Rs-fMRI can localize the sensorimotor cortex successfully, providing anatomical specificity for hand, foot and mouth motor subregions, in particular with seed-based analyses. Agreement with tb-fMRI was only partial and rs-fMRI tended to provide larger patterns of correlated activity. With respect to the ECS data available, rs-fMRI and tb-fMRI performed comparably, even though the shortest distance to stimulation points was observed for the latter. Notably, the results of both were on the whole robust to thresholding procedure. Localization performed by rs-fMRI is not equivalent to tb-fMRI, hence rs-fMRI cannot be considered as an outright replacement for tb-fMRI. Nevertheless, since there is significant agreement between the two techniques, rs-fMRI can be considered with caution as a potential alternative to tb-fMRI when patients are unable to perform the task.
静息态功能磁共振成像（rs-fMRI）最近被认为是术前映射中基于任务的功能磁共振成像（tb-fMRI）的一种可能补充或替代方法。然而，其有用性的证据仍然很少，因为现有研究调查的样本相对较小，并且主要集中在定性评估上。本研究的目的是在运动功能术前映射的背景下研究rs-fMRI的临床有用性，特别是确定与tb-fMRI的对应程度，tb-fMRI虽不是金标准，但在术前环境中常用。一组13名病变靠近感觉运动皮层的患者接受了rs-fMRI和tb-fMRI检查，以定位手、脚和口部运动区域。我们定量评估了多种rs-fMRI分析（独立成分分析和基于种子的分析）与tb-fMRI之间的对应程度，参考了rs-fMRI相对于tb-fMRI的敏感性和特异性以及质心距离。还研究了与皮层电刺激（ECS）的一致性，并将基于两位经验丰富的操作人员之间一致性的传统图谱阈值化方法与自动阈值确定方法进行了比较。rs-fMRI能够成功定位感觉运动皮层，为手、脚和口部运动子区域提供解剖学特异性，特别是基于种子的分析。与tb-fMRI的一致性只是部分的，并且rs-fMRI倾向于提供更大的相关活动模式。关于可用的ECS数据，rs-fMRI和tb-fMRI表现相当，尽管后者观察到到刺激点的最短距离。值得注意的是，两者的结果总体上对阈值化程序具有稳健性。rs-fMRI执行的定位与tb-fMRI不等同，因此rs-fMRI不能被视为tb-fMRI的直接替代方法。然而，由于这两种技术之间存在显著一致性，当患者无法执行任务时，rs-fMRI可以谨慎地被视为tb-fMRI的潜在替代方法。
