Department of Neurological Surgery, University of California, San Francisco (UCSF), 505 Parnassus Avenue Room M779, San Francisco, CA, 94143-0112, USA.
Neurosurg Rev. 2019 Sep;42(3):639-647. doi: 10.1007/s10143-018-1007-4. Epub 2018 Jul 13.
Functional brain mapping (FBM) is an integral part of contemporary neurosurgery. It is crucial for safe and optimal resection of brain lesions like gliomas. The eloquent regions of the cortex like motor, somatosensory, Wernicke's, and Broca are usually mapped, either preoperatively or intraoperatively. Since its birth in the nineteenth century, FBM has witnessed immense modernization, radical refinements, and the introduction of novel techniques, most of which are non-invasive. Direct electrical stimulation of the cortex, despite its high invasiveness, remains the technique of choice. Non-invasive techniques like fMRI and magnetoencephalography allow us the convenience of multiple mappings with minimal discomfort to the patients. They are quick, easy to do, and allow thorough study. Different modalities are now being combined to yield better delineations like fMRI and diffusion tensor imaging. This article reviews the physical principles, applications, merits, shortcomings, and latest developments of nine FBM techniques. Other than neurosurgical operations, these techniques have also been applied to studies of stroke, Alzheimer's, and cognition. There are strong indications that the future of brain mapping shall see the non-invasive techniques playing a more dominant role as they become more sensitive and accurate due to advances in physics, refined algorithms, and subsequent validation against invasive techniques.
功能脑图（FBM）是当代神经外科不可或缺的一部分。它对于安全和优化脑肿瘤等病变的切除至关重要。通常会对大脑皮质的运动、感觉、韦尼克和布洛卡等功能区进行术前或术中的功能定位。自 19 世纪诞生以来，FBM 经历了巨大的现代化、彻底的精细化以及新技术的引入，其中大多数是无创的。尽管皮层直接电刺激具有高度的侵袭性，但它仍然是首选技术。像 fMRI 和脑磁图这样的无创技术为我们提供了便利，可以对患者进行多次映射，同时又不会带来太大的不适。它们快速、易于操作，并允许进行全面的研究。现在不同的模态正在被组合以产生更好的描绘，如 fMRI 和弥散张量成像。本文综述了 9 种 FBM 技术的物理原理、应用、优点、缺点和最新进展。除了神经外科手术外，这些技术还被应用于中风、阿尔茨海默病和认知的研究。有强烈的迹象表明，由于物理学的进步、精细化的算法以及对侵袭性技术的后续验证，无创技术会变得更加敏感和准确，因此在脑图技术中，它们将扮演更主导的角色。
