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Clinical Functional MRI pp 247–267Cite as

Presurgical Functional Localization Possibilities, Limitations, and Validity

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Part of the book series: Medical Radiology ((Med Radiol Diagn Imaging))

Abstract

Over the last two decades, presurgical mapping using functional neuroimaging techniques – and particularly fMRI – has made considerable progress. FMRI is now commonly used in the clinical practice and not just for research applications. Presurgical functional neuroimaging with its contributions to surgical planning and to the prediction of postoperative outcome is now well established.

Validation studies of functional imaging techniques have shown the potential of fMRI to localize motor areas and also to lateralize and localize language and, more recently, memory functions. However, particularly for cognitive brain functions, the imaging results strongly depend on the methodology requiring optimal clinical standard procedures. Currently, functional neuroimaging is considered as complementary to direct electrical stimulations (DES) providing additional information, such as information on the entire functional network and on the contralateral hemisphere, which is not accessible to DES. Until now, fMRI cannot replace DES. In contrast, for language functions, fMRI has largely replaced the intracarotid amobarbital procedure (IAP), which could be the case also for memory functions in the near future. Diffusion tensor imaging (DTI) fiber tracking is a more recent, but already in some centers, well-established technique, and its value in presurgical mapping requires further work.

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Authors and Affiliations

  1. Centre de NeuroImagerie de Recherche – CENIR, Institut du Cerveau et de la Moelle – ICM, Sorbonne Universités, UPMC Univ Paris 06, UMR S 1127, CNRS UMR 7225, Paris, France

    Stéphane Lehéricy MD, PhD

  2. Department of Neuroradiology, Groupe Hospitalier Pitié-Salpêtrière, Université Pierre et Marie Curie – Paris 6, 47-83, boulevard de l’hôpital, Paris, 75651, France

    Stéphane Lehéricy MD, PhD & Delphine Leclercq MD

  3. Department of Neurosurgery, Hôpital Gui de Chauliac and INSERM U1051, Montpellier University Medical Center, Montpellier, France

    Hugues Duffau MD, PhD

  4. Center for Magnetic Resonance Research, University of Minnesota, 2021 Sixth Street SE, Minneapolis, MN, 55455, USA

    Pierre-François Van de Moortele MD, PhD

  5. Department of Neuroradiology, CHRU Lille, Hopital Roger Salengro, boulevard du Pr Leclerc, Lille cedex, 59800, France

    Christine Delmaire MD

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  1. Stéphane Lehéricy MD, PhD
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  3. Hugues Duffau MD, PhD
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  1. Division of Diagnostic and Interventional Neuroradiology, University Hospitals Basel, Basel, Switzerland

    Christoph Stippich

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Lehéricy, S., Leclercq, D., Duffau, H., Van de Moortele, PF., Delmaire, C. (2015). Presurgical Functional Localization Possibilities, Limitations, and Validity. In: Stippich, C. (eds) Clinical Functional MRI. Medical Radiology(). Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-45123-6_9

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