[Functional magnetic resonance imaging: Physiological background, technical aspects and prerequisites for clinical use]

Magnetic Microcarriers with Accurate Localization and Proliferation of Mesenchymal Stem Cell for Cartilage Defects Repairing

Magnetic biomaterials are widely used in the field of tissue engineering because of their functions such as drug delivery and targeted therapy. In this study, a magnetically responsive composite microcarrier was prepared through in situ polymerization of dopamine with Fe₃O₄ (MS) to form a complex. The magnetic composite microcarriers are paramagnetic and have certain magnetic responsiveness, suitable pore size porosity for cell growth, and good blood compatibility and biocompatibility. The bone marrow mesenchyml stem cells (BMSCs) were cultured on magnetic composite microcarriers, and a static magnetic field (SMF) was applied. The results showed that BMSCs adhered to the microcarriers proliferated under the action of horizontal and vertical forces. Magnetic composite microcarriers loaded with BMSCs were implanted into the SD rat model of cartilage defect, and a magnet was added to the operative side. After 12 weeks, cartilage regeneration was observed. The results of gross observation and histological immunostaining 1 month, 2 months, and 3 mounths after operation showed that the magnetic composite microcarriers of loaded cells promoted the early maturation of cartilage and collagen secretion, and the effect of cartilage repair was significantly better than that of the control group. Gait analysis showed that implanting magnetic composite microcarriers loaded with stem cells can reduce postoperative pain and promote limb recovery in SD rats. In conclusion, this study suggests that magnetic composite microcarriers are promising tissue-engineered scaffolds for cartilage regeneration and repair.

Task-Based and Resting-State Functional MRI in Observing Eloquent Cerebral Areas Personalized for Epilepsy and Surgical Oncology Patients: A Review of the Current Evidence

Functional magnetic resonance imaging (fMRI) is among the newest techniques of advanced neuroimaging that offer the opportunity for neuroradiologists, neurophysiologists, neuro-oncologists, and neurosurgeons to pre-operatively plan and manage different types of brain lesions. Furthermore, it plays a fundamental role in the personalized evaluation of patients with brain tumors or patients with an epileptic focus for preoperative planning. While the implementation of task-based fMRI has increased in recent years, the existing resources and evidence related to this technique are limited. We have, therefore, conducted a comprehensive review of the available resources to compile a detailed resource for physicians who specialize in managing patients with brain tumors and seizure disorders. This review contributes to the existing literature because it highlights the lack of studies on fMRI and its precise role and applicability in observing eloquent cerebral areas in surgical oncology and epilepsy patients, which we believe is underreported. Taking these considerations into account would help to better understand the role of this advanced neuroimaging technique and, ultimately, improve patient life expectancy and quality of life.

Functional MRI in Radiology—A Personal Review

We, here, provide a personal review article on the development of a functional MRI in the radiology departments of two German university medicine units. Although the international community for human brain mapping has met since 1995, the researchers fascinated by human brain function are still young and innovative. However, the impact of functional magnetic resonance imaging (fMRI) on prognosis and treatment decisions is restricted, even though standardized methods have been developed. The tradeoff between the groundbreaking studies on brain function and the attempt to provide reliable biomarkers for clinical decisions is large. By describing some historical developments in the field of fMRI, from a personal view, the rise of this method in clinical neuroscience during the last 25 years might be understandable. We aim to provide some background for (a) the historical developments of fMRI, (b) the establishment of two research units for fMRI in the departments of radiology in Germany, and (c) a description of some contributions within the selected fields of systems neuroscience, clinical neurology, and behavioral psychology.

Effects of using different software packages for BOLD analysis in planning a neurosurgical treatment in patients with brain tumours

BACKGROUND

The authors of the present thesis carried out a comparative analysis of three different computer software packages - FSL, SPM and FuncTool - for the processing of fMRI scans.

PURPOSE

The aim of the thesis was the analysis of the volume of regions functionally active during the stimulation of the centres evaluated as well as the location of those regions in relation to the tumour boundaries, and then the comparison of the results.

MATERIAL AND METHODS

Thirty eight patients with a diagnosed tumour of the left hemisphere, qualified for a neurosurgical operation, underwent fMRI. The functions of speech, motion and sensation were evaluated. Imaging data were processed for all the acquired scans with the use of each of the three software packages assessed.

RESULTS

For the FuncTool software package the calculated differences in the distances were several times greater than those calculated using FSL and SPM. The differences in the volume of the functionally active regions derived from the calculations with the use of the FSL and SPM software packages were statistically different for four out of the six functions evaluated.

CONCLUSIONS

The conclusions of the analysis in question showed that the FSL and SPM packages could be used interchangeably in the functional mapping of the brain with the purpose of the planning of neurosurgical operations. The FuncTool software package is less precise than FSL and SPM.

EEG-based Classification of Lower Limb Motor Imagery with Brain Network Analysis

This study aims to investigate the difference in cortical signal characteristics between the left and right foot imaginary movements and to improve the classification accuracy of the experimental tasks. Raw signals were gathered from 64-channel scalp electroencephalograms of 11 healthy participants. Firstly, the cortical source model was defined with 62 regions of interest over the sensorimotor cortex (nine Brodmann areas). Secondly, functional connectivity was calculated by phase lock value for α and β rhythm networks. Thirdly, network-based statistics were applied to identify whether there existed stable and significant subnetworks that formed between the two types of motor imagery tasks. Meanwhile, ten graph theory indices were investigated for each network by t-test to determine statistical significance between tasks. Finally, sparse multinomial logistic regression (SMLR)-support vector machine (SVM), as a feature selection and classification model, was used to analyze the graph theory features. The specific time-frequency (α event-related desynchronization and β event-related synchronization) difference network between the two tasks was congregated at the midline and demonstrated significant connections in the premotor areas and primary somatosensory cortex. A few of statistically significant differences in the network properties were observed between tasks in the α and β rhythm. The SMLR-SVM classification model achieved fair discrimination accuracy between imaginary movements of the two feet (maximum 75% accuracy rate in single-trial analyses). This study reveals the network mechanism of the discrimination of the left and right foot motor imagery, which can provide a novel avenue for the BCI system by unilateral lower limb motor imagery.

Acoustically presented semantic decision-making tasks provide a robust depiction of the temporo-parietal speech areas

Functional MRI (fMRI) is routinely used to depict language areas, for example in the preoperative diagnostic work-up of patients with a brain tumour. The objective of this study was to test whether semantic decision making can activate the temporo-parietal language areas better than phonological generation stimuli. Five fMRI language stimuli were tested in 20 healthy volunteers: (i) word generation to a given letter (WG); (ii) verb generation to a given noun (VG); (iii) generation of groups of words (GW); (iv) detection of a semantic violation in sentences (SV); and (v) detection of pseudowords (PW). The stimuli were presented both visually and acoustically. We used a block design and evaluated the data with SPM5 with predefined regions of interest in the frontal and temporo-parietal language areas. A lateralisation index (LI) was also calculated. We found that WG and VG achieved the best results in frontal language areas; VG, SV and PW presented acoustically achieved the best results in the temporo-parietal language areas; and that LI was most reliably calculated in the frontal language areas. An acoustically presented semantic decision making stimulus should be implemented in the preoperative diagnostic work-up to robustly depict the temporo-parietal language areas. The stimulus is easy to understand and perform, and it achieves robust results.

A blood pool contrast aided T1 functional MRI in patients with brain tumors--a preliminary study

INTRODUCTION

The aim of our study was to determine the possibility of using a new functional technique: a T1-dependent sequence with administration of blood pool contrast agent (BPCA), in patients with brain tumors before and after surgical treatment. We also aimed to compare our results with those obtained using the fMRI technique, based on Blood Oxygenation Level-Dependent (BOLD) contrast.

METHODS

For each of our 14 oncologic patients (four before and ten after neurosurgical intervention), we obtained: a T1-3D GRE sequence (TR = 2.6 ms/TE = 1.1 ms/FA = 10°) after intravenous administration of BPCA (0.03 mmol/kg), as well as a T2*EPI sequence (TR = 3 s/TE = 50 ms/FA = 90°). Movement and/or tactile block type paradigms were carried out during both functional runs. SPM5 software was used for analysis.

RESULTS

For both functional techniques, maximum activations were localized in the same areas. There were no significant differences observed in the t values calculated for activations located in the primary motor cortex between groups of pre- and post-intervention patients (in the same functional technique). The mean values for T2* EPI examinations were 10.84 and 9.36, respectively. The mean t values for the T1 technique were lower, especially for the post-intervention patients (5.83 and 3.9, respectively).

CONCLUSIONS

The T1 technique can be used to detect functional areas in patients with brain tumors, pre-, and post-surgical intervention. This technique enables the evaluation of cortical centers that suffer from susceptibility artifacts when using the T2* BOLD technique. Activations found using both techniques have the same localization, with lower values for the T1 technique.

Localizing and Lateralizing Language in Patients with Brain Tumors: Feasibility of Routine Preoperative Functional MR Imaging in 81 Consecutive Patients1

PURPOSE

To prospectively assess the feasibility of standardized presurgical functional magnetic resonance (MR) imaging for localizing the Broca and Wernicke areas and for lateralizing language function.

MATERIALS AND METHODS

The study was approved by the responsible ethics commission, and patients gave written informed consent. Eighty-one patients (36 female and 45 male patients; age range, 7-75 years) with different brain tumors underwent blood oxygen level-dependent functional MR imaging at 1.5 T with two paradigms: sentence generation (SG) and word generation (WG). Functional MR imaging measurements, data processing, and evaluation were fully standardized by using dedicated software. Four regions of interest were evaluated in each patient: the Broca and Wernicke areas and their anatomic homologues in the right hemisphere. Statistics were calculated.

RESULTS

The SG and WG paradigms were successfully completed by all (100%) and 70 (86%) patients, respectively. Success rates in localizing and lateralizing language were 96% for the Broca and Wernicke areas with the SG paradigm, 81% for the Broca area and 80% for the Wernicke area with the WG paradigm, and 98% for both areas when the SG and WG paradigms were used in combination. Functional localizations were consistent for SG and WG paradigms in the inferior frontal gyrus (Broca area) and the superior temporal, supramarginal, and angular gyri (Wernicke area). Surgery was not performed in seven patients (9%) and was modified in two patients (2%) because of functional MR imaging findings.

CONCLUSION

Functional MR imaging proved to be feasible during routine diagnostic neuroimaging for localizing and lateralizing language function preoperatively.

Real time fMRI: a tool for the routine presurgical localisation of the motor cortex

In patients with brain lesions adjacent to the central area, exact preoperative knowledge of the spatial relation of the tumour to the motor cortex is of major importance. Many studies have shown that functional magnetic resonance imaging (fMRI) is a reliable tool to identify the motor cortex. However, fMRI data acquisition and data processing are time-consuming procedures, and this prevents general routine clinical application. We report a new application of real time fMRI that allows immediate access to fMRI results by automatic on-line data processing. Prior to surgery we examined ten patients with a brain tumour adjacent to the central area. Three measurements were performed at a 1.5-T Magnetom Vision Scanner (Siemens, Forchheim, Germany) on seven patients and at a 1.5-T Intera Scanner (Philips, Best, The Netherlands) on three patients using a sequential finger-tapping paradigm for motor cortex activation versus at rest condition. Blood oxygen level-dependant (BOLD) images were acquired using a multislice EPI sequence (16 slices, TE 60, TR 6000, FOV 210x210, matrix 64x64). The central sulcus of the left hemisphere could be clearly identified by a maximum of cortical activity after finger tapping of the right hand in all investigated patients. In eight of ten patients the right central sulcus was localised by a signal maximum, whereas in two patients the central sulcus could not be identified due to a hemiparesis in one and strong motion artefacts in the second patient. Finger tapping with one side versus rest condition seems to result in more motion artefacts, while finger tapping of the right versus the left hand yielded the strongest signal in the central area. Real time fMRI is a quick and reliable method to identify the central sulcus and has the potential to become a clinical tool to assess patients non-invasively before neurosurgical treatment.

Robust localization and lateralization of human language function: an optimized clinical functional magnetic resonance imaging protocol

An optimized clinical functional magnetic resonance imaging (fMRI) protocol with a total scanning time of 8 min is presented that localizes Broca's and Wernicke's areas robustly and determines hemispheric dominance. Language function was visualized using two different sentence generation (SG) and word generation (WG) tasks. Block designed blood oxygenation level dependent (BOLD) fMRI was applied in 14 right-handed volunteers at 1.5 T during visual stimulation. BOLD-clusters were assessed individually for anatomical localization. Reference data are provided for the maximum correlation of the measured BOLD-signal time course to the applied reference function (r(max)), for the maximum relative signal change (dS%), cluster size and Euklidian coordinates of Broca and Wernicke activation and of the anatomical homologues in the right hemispheres. Statistical means and a lateralization index (LI) were calculated. Broca activation focussed on the inferior frontal gyrus, and Wernicke activation on the superior temporal, supramarginal or middle temporal gyri. Mean BOLD-signals for Broca ranged from 1.53% (SG) to 2.56% (WG), and for Wernicke from 1.47% (SG) to 1.80% (WG). LI indicated left language dominance. The data provided further evidence for the high anatomical variability of language areas, which underlined the relevance of an individual language localization and lateralization prior to brain surgery.