Cortical intraoperative stimulation in brain tumors as a tool to evaluate spatial data from motor functional MRI

RATIONALE AND OBJECTIVE. The purpose of this prospective, double-blind stud y was to correlate motor functional MRI (fMRI) with cortical brain mapping by intraoperative stimulation using 3D reconstructed images of the surface of the brain, and to validate the spatial data of fMRI in patients with bra in tumors. METHODS. Fourteen patients with tumors of the rolandic region underwent fun ctional MR mapping of the hand region and subsequently cortical mapping bef ore tumor resection. Data obtained with fMRI and brain mapping were not kno wn previously by the neurosurgeon and by the neuroradiologist, respectively (double-blind study). RESULTS. In each case, the results of direct cortical mapping matched those obtained with fMRI, both positively and negatively, although the extent of the functional activations was larger than the area required to elicit the corresponding movement during intraoperative brain mapping. CONCLUSION. fMRI can be used before surgery to assess motor functional area ill patients with rolandic tumors, More studies are needed to validate dur ing surgery the real extent of fMRI activations.