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  • Title: fMRI Resting-State Connectivity between Language and Nonlanguage Areas as Defined by Intraoperative Electrocortical Stimulation in Low-Grade Glioma Patients.
    Author: van Lieshout J, Debaene W, Rapp M, Noordmans HJ, Rutten GJ.
    Journal: J Neurol Surg A Cent Eur Neurosurg; 2021 Jul; 82(4):357-363. PubMed ID: 33618418.
    Abstract:
    BACKGROUND AND OBJECTIVES:  It remains to be determined whether noninvasive functional imaging techniques can rival the clinical potential of direct electrocortical stimulation (DES). In this study, we compared the results of resting-state functional magnetic resonance imaging (rs-fMRI) to those of DES for language mapping. Our goals were twofold: (1) to replicate a previous study that demonstrated that resting-state connectivity (RSC) was significantly larger between positive DES language sites than between negative DES language sites and (2) to compare the spatial resolution of rs-fMRI to that of DES. METHODS:  We conducted a retrospective study of nine low-grade glioma patients. Language sites were identified by intraoperative DES. We compared RSC values between and within groups of DES-positive and DES-negative regions of interest (ROIs). Both close-negative sites (i.e., DES-negative sites <1 cm apart from and on the same gyrus as DES-positive sites) and far-negative sites (i.e., purely randomly chosen sites not in the vicinity of the tumor or of the DES-positive sites but on the same lobe) were included. Receiver operating characteristics were used to quantify comparisons. RESULTS:  Functional connectivity between all positive language sites was on average significantly higher than between all close-negative sites and between all far-negative sites. The functional connectivity between the positive language ROIs and their respective close-negative control sites was not smaller than between all positive language sites. CONCLUSION:  rs-fMRI likely reflects similar neural information as detected with DES, but in its current form does not reach the spatial resolution of DES.
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