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Paradigms for Clinical fMRI

Keith R. Thulborn¹, Denise Davis¹

¹University of Illinois at Chicago, Chicago, Illinois

Publication Name:

Current Protocols in Magnetic Resonance Imaging

Unit Number:

Unit A6.3

DOI:

10.1002/0471142719.mia0603s00

Online Posting Date:

May, 2001

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Abstract

This unit presents description of four basic clinical paradigms for clinical fMRI of language cmprehension, eye movement (visually guidede saccades), motor cortex (finger-thumb apposition), and visual cortex. Given the neurosurgical concern with preservation of eloquent cortex, brain functions of particular interest are primary sensory (e.g., visual, auditory) and motor functions, and high level processing of language comprehension and expression. Compromise of these functions is usually readily apparent clinically and the quality of life of the patient is severely diminished. Functional MRI offers a means to locate these functions, thereby allowing the surgeon to plan on preserving these functions, or prepare the patient appropriately.

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Unit Introduction
Paradigms
Commentary
Literature Cited
Figures

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Figures

Figure A6.3.1

Representative activation map at 1.5 T for the language paradigm, showing extensive network activation with areas of frontal eye fields (FEF, precentral sulcus), supplementary eye fields (SEF, medial frontal cortex), intraparietal sulcus (IPS), prefrontal cortex (PFC), Broca's area (BA, left inferior frontal cortex), homologous Broca's area (hBA, right inferior frontal cortex), Wernicke's area (WA, left superior temporal gyrus), and visual cortex (V1, calcarine sulcus). This pattern is observed in adults irrespective of gender or handedness. The color scale indicates the t-test statistic for activation. The higher t-statistic (yellow) has greater statistical significance. See color plate.

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Figure A6.3.2

Representative activation map at 1.5 T for the visually guided saccade paradigm which is used as a control for the language paradigm. The areas of activation (FEF, SEF, IPS, V1, MT/V5) are similar except for the absence of Broca's (BA) and Wernicke's areas (WA), involved in language comprehension. This pattern is observed in both young and elderly adults. See color plate.

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Figure A6.3.3

Representative activation map at 1.5 T for the motor paradigm with bilateral finger-thumb apposition in which motor (M1), supplementary motor area (SMA), and somatosensory (S1) activation are observed. This pattern has been reported in normal adults from multiple laboratories. See color plate.

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Figure A6.3.4

Representative activation map at 1.5 T for the visual paradigm in which a flashing checkerboard stimulus is shown to the (A) left upper quadrant and (B) right upper quadrant. The clear contralateral activation in the calcarine fissure indicates that the subject did maintain central fixation for the entire task. Bilateral stimulation indicates lack of central fixation. V5 (also termed MT) is the area of visual association cortex involved in detection of visual motion. IPS and V1 are the intraparietal sulcus and primary visual cortex, respectively. See color plate.

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Literature Cited

Literature Cited
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	Booth, J.R., MacWhinney, B., Thulborn, K.R., Sacco, K., Voyvodic, J., and Feldman, H.M. 1999. Functional organization of activation patterns in children: Whole brain fMRI imaging during three different cognitive tasks. Prog. Neuro-Psychopharmacol. Biol. Psychiatry 23:669-682.
	Just, M.A., Carpenter, P.A., Keller, T.A., Eddy, W.F., and Thulborn, K.R. 1996. Brain activation modulated by sentence comprehension. Science 274:114-116.
	Luna, B., Thulborn, K.R., Strojwas, M.H., McCurtain, B.J., Berman, R.A., Genovese, C.R., and Sweeney, J.A. 1998. Dorsal cortical regions subserving visually-guided saccades in humans: A fMRI study. Cereb. Cortex 8:40-47.
	Luna, B. and Sweeney, J.A. 1999. Cognitive functional magnetic resonance imaging at very-high-field: Eye movement control. Topics Magn. Reson. Imaging 10:3-15.
	Marquart, M., Birn, R., and Haughton, V. 2000. Single- and multiple-event paradigms for identification of motor cortex activation. Am. J. Neuroradiol. 21:94-98.
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	Thulborn, K.R., Carpenter, P.A., and Just, M.A. 1999a. Plasticity of language-related brain function during recovery from stroke. Stroke 30:749-754.
	Thulborn, K.R., Gindin, T.S., Davis, D., and Erb, P. 1999b. Comprehensive MRI protocol for stroke management: Tissue sodium concentration as a measure of tissue viability in a non-human primate model and clinical studies. Radiology 139:26-34.
	Thulborn, K.R., Martin, C., and Voyvodic, J. 2000. fMRI using a visually guided saccade paradigm in Alzheimer's disease. Am. J. Neuroradiol. 21:524-531.
	Wessinger, C.M., Buonocore, M.H., Kussmaul, C.L., and Mangun, G.R. 1997. Tonotopy in human auditory cortex examined with functional magnetic resonance imaging. Human Brain Mapp. 5:18-25.