Typical paradigms are repetitive flexion of the foot, thumb-to-finger opposition, and movement of the tongue with the mouth closed ( Krings et al., 2001). Mapping of the motor and somatosensory cortices with fMRI is an established technique to identify the cortical representation of the foot ( Fig. However, there are multiple small-sample-size studies of patients with brain tumors in the literature demonstrating that preoperative fMRI alters surgical management significantly ( Pillai, 2010). Large randomized controlled trials demonstrating a beneficial effect of presurgical fMRI on patient outcome are lacking ( Buchbinder, 2016) because they are very difficult to accomplish. A major limitation of clinical fMRI is that despite recent initiatives (e.g., by the American Society of Functional Neuroradiology Neuroradiology, 2019), official recommendations or guidelines for the performance, evaluation, and interpretation of presurgical fMRI examinations are lacking ( Szaflarski et al., 2017) and only a few studies are evaluating larger patients samples under standardized fMRI conditions ( Krings et al., 2001 Tyndall et al., 2017). Task-based BOLD fMRI enables the evaluation of the spatial relationship between an intracranial lesion and different cortical functional areas (e.g., primary motor cortex or lateralization of essential language areas Stippich, 2015).Ĭontrary to research fMRI studies, presurgical clinical fMRI is usually based on a simple block design and the control condition is usually rest or visual fixation.
Since its first description in 1992 ( Ogawa, 2012 ), fMRI based on BOLD contrast has gained an important role in presurgical brain mapping. Joseph Jankovic MD, in Bradley and Daroff's Neurology in Clinical Practice, 2022 Presurgical Brain Mapping
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