Department of Radiology, CUB-Hôpital Erasme, Université libre de Bruxelles (ULB), 808 route de Lennik, 1070, Brussels, Belgium; Laboratoire de Cartographie fonctionnelle du Cerveau (LCFC), ULB Neuroscience Institute (UNI), CUB-Hôpital Erasme, Université libre de Bruxelles (ULB), 808 route de Lennik, 1070, Brussels, Belgium.
Laboratoire de Cartographie fonctionnelle du Cerveau (LCFC), ULB Neuroscience Institute (UNI), CUB-Hôpital Erasme, Université libre de Bruxelles (ULB), 808 route de Lennik, 1070, Brussels, Belgium; Department of Functional Neuroimaging, Service of Nuclear Medicine, CUB-Hôpital Erasme, Université libre de Bruxelles (ULB), 808 route de Lennik, 1070, Brussels, Belgium.
J Neurosci Methods. 2021 Jul 15;359:109227. doi: 10.1016/j.jneumeth.2021.109227. Epub 2021 May 27.
Two concerns with respect to pre-operative task-based motor functional magnetic resonance imaging (fMRI) in patients with brain tumours are inadequate performance due to patients' impaired motor function and head motion artefacts.
In the present study we validate the use of a stimulator based on a pneumatic artificial muscle (PAM) for fMRI mapping of the primary sensorimotor (SM1) cortex in twenty patients with rolandic or perirolandic brain tumours. All patients underwent both active and passive motor block-design fMRI paradigms, performing comparable active and passive PAM-induced flexion-extensions of the icontralesional index finger.
PAM-induced movements resulted in a significant BOLD signal increase in contralateral primary motor (M1) and somatosensory (S1) cortices in 18/20 and 19/20 (p<.05 FWE corrected in 16/18 and 18/19) patients, versus 18/20 and 16/20 (p<.05 FWE corrected) during active movements. The two patients in whom the PAM-based stimulator failed to induce any significant BOLD signal change in the contralateral M1 cortex differed from the two in whom active motion was conversely ineffective. At the group level, no significant difference in contrast magnitude was observed within the contralateral SM1 cortex when comparing active with passive movements. During passive movements, head motion was significantly reduced. Comparison with existing method(s) As compared to the several robotic devices for passive motion that were introduced in the past decades, our PAM-based stimulator appears smaller, handier, and easier to use.
The use of PAM-based stimulators should be included in routine pre-operative fMRI protocols along with active paradigms in such patients' population.
术前基于任务的功能磁共振成像（fMRI）在脑肿瘤患者中的应用存在两个问题，即患者运动功能受损和头部运动伪影导致的成像效果不佳。
本研究验证了气动人工肌肉（PAM）刺激器在 20 例岛叶或岛盖旁脑肿瘤患者的初级感觉运动（SM1）皮质 fMRI 图谱中的应用。所有患者均接受主动和被动运动阻断设计 fMRI 范式，以相同的方式对健侧示指进行主动和被动 PAM 诱导的屈伸运动。
在 18/20 例和 19/20 例（校正后 p<.05）患者中，PAM 诱导的运动导致对侧初级运动（M1）和体感（S1）皮质的显著 BOLD 信号增加，而在 18/20 例和 16/20 例（校正后 p<.05）患者中，主动运动则导致显著的 BOLD 信号增加。在对侧 M1 皮质中，两名患者的 PAM 刺激器未能引起任何显著的 BOLD 信号变化，而这两名患者的主动运动则相反无效。在组水平上，在比较主动运动和被动运动时，对侧 SM1 皮质中的对比度没有显著差异。在被动运动期间，头部运动明显减少。与现有方法的比较与过去几十年中引入的几种用于被动运动的机器人设备相比，我们的 PAM 刺激器体积更小、更便携，且使用更简单。
在这类患者人群中，PAM 刺激器应与主动范式一起纳入常规术前 fMRI 方案中。
