BOLD functional MRI may overlook activation areas in the damaged brain.
ABSTRACT Clinical applications of blood-oxygenation-level-dependent contrast functional MRI (BOLD-fMRI) have been rapidly moving toward routine non-invasive cortical mapping in the patients with brain disorders. However, it is not yet clear whether the damaged brain shows same cerebral blood oxygenation (CBO) changes during neuronal activation as those in the normal adult. We compared the activation mapping obtained by BOLD-fMRI and the evoked-CBO changes measured by near infrared spectroscopy (NIRS) in normal adults (6 cases) and patients with damaged brain (6 cases of cerebral ischemia and 10 cases of brain tumors in or adjacent to the motor cortex). BOLD-fMRI demonstrated robust activation areas in the primary sensorimotor cortex (PSMC) during contralateral hand grasping tasks in all of the normal adults; however, in the cerebral ischemia (6 cases) and the brain tumors (2 cases), BOLD-fMRI demonstrated only limited activation areas in the PSMC on the lesion side during the task. NIRS demonstrated an increase of focal concentration of oxyhemoglobin and total hemoglobin at the PSMC during the task in all of the normal adults and the patients, indicating the presence of rCBF increase in response to neuronal activation. A focal concentration of deoxyhemoglobin decreased during the task in the normal adults, however, in the patients that showed limited activation areas by BOLD-fMRI, deoxyhemoglobin concentrations increased during the entire course of the task. In summary, the evoked-CBO changes occurring in the damaged brain differed from those in the normal brain. This indicates that BOLD-fMRI may overlook activation areas in the damaged brain.
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ABSTRACT: HARRISON, A. H., and J. F. Connolly. Finding a way in: A review and practical evaluation of fMRI and EEG in disorders of consciousness. NEUROSCI BIOBEHAV REV XX(X) XXX-XXX, 2013. Diagnoses and assessments of cognitive function in disorders of consciousness (DOC) are notoriously prone to error due to their reliance on behavioural measures. As a result, researchers have turned to functional neuroimaging and electrophysiological techniques with the goal of developing more effective methods of detecting awareness and assessing cognition in these patients. This article reviews functional magnetic resonance imaging (fMRI) and electroenchphalography (EEG)-based studies of cognition and consciousness in DOC, including assessment of basic sensory, perceptual, language, and emotional processing; studies for detection of conscious awareness; paradigms for the establishment of communication in the absence of behaviour; and functional connectivity studies. The advantages and limitations of fMRI and EEG-based measures are examined as research and clinical tools in this population and an explanation offered for the rediscovery of the unique advantages of EEG in the study of DOC.Neuroscience & Biobehavioral Reviews 05/2013; 37(8). DOI:10.1016/j.neubiorev.2013.05.004 · 10.28 Impact Factor
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ABSTRACT: First described for use in mapping the human visual cortex in 1991, functional magnetic resonance imaging (fMRI) is based on blood-oxygen level dependent (BOLD) changes in cortical regions that occur during specific tasks. Typically, an overabundance of oxygenated (arterial) blood is supplied during activation of brain areas. Consequently, the venous outflow from the activated areas contains a higher concentration of oxyhemoglobin, which changes the paramagnetic properties of the tissue that can be detected during a T2-star acquisition. fMRI data can be acquired in response to specific tasks or in the resting state. fMRI has been widely applied to studying physiologic and pathophysiologic diseases of the brain. This review will discuss the most common current clinical applications of fMRI as well as emerging directions.Seminars in Neurology 09/2012; 32(4):466-75. DOI:10.1055/s-0032-1331816 · 1.78 Impact Factor
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