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Functional Brain Mapping Options for Minimally Invasive Neurosurgery

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Minimally Invasive Neurosurgery

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Abstract

Minimally invasive intracranial neurosurgery depends on the ability to localize accurately the operative target and its relationship to any neighboring eloquent areas. There are several methods of mapping cortical function, including the intracarotid amytal injection test (IAT or Wada test), positron emission tomography (PET), magnetoencephalography (MEG), direct electro-cortical stimulation (ECS), transcranial magnetic stimulation (TMS), and functional magnetic resonance imaging (fMRI). Some of these tests (PET, FMRI, and MEG) are activation techniques, meaning they demonstrate brain activation, which occurs when the subject performs a particular behavioral task. In contrast, the tests traditionally used for the determination of eloquent cortex (ECS, IAT) are essentially deactivation techniques, meaning that a temporary brain lesion is created pharmacologically or electrically and behavioral effects are measured. Deactivation studies are well suited to the pre-resection evaluation of cortical function because they mimic the effects of resection of the tissue; however, their use is limited by their invasiveness. Transcranial magnetic stimulation is a promising and relatively less invasive deactivation technique that can be performed through an intact skull.

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Authors and Affiliations

  1. Department of Neurosurgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA

    Alexandra J. Golby MD

  2. Department of Radiology, New York University, New York, NY

    Kathleen A. McConnell MD

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  1. Alexandra J. Golby MD
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  2. Kathleen A. McConnell MD
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Editors and Affiliations

  1. Department of Neurosurgery, The Children’s Hospital, Harvard Medical School, Boston, MA

    Mark R. Proctor MD  & Peter M. Black MD, PhD  & 

  2. Department of Neurosurgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA

    Peter M. Black MD, PhD

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Golby, A.J., McConnell, K.A. (2005). Functional Brain Mapping Options for Minimally Invasive Neurosurgery. In: Proctor, M.R., Black, P.M. (eds) Minimally Invasive Neurosurgery. Humana Press. https://doi.org/10.1385/1-59259-899-4:087

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