Functional MRI (fMRI) on lesions in and around the motor and the eloquent cortices

From the view point of neurosurgeons, to aim the preoperative localized diagnosis on the motor and the eloquent cortices and postoperative preservation of neurological functions, fMRI was carried for patients with lesions in and around the motor and the eloquent cortices. Even in cases of mechanical oppression or brain edema, the motor and the eloquent cortices are localized on cerebral gyri. In perioperative period, identification and preserving the motor and the eloquent cortices are important for keeping brain function. Twenty six preoperative cases and 3 normal healthy subjects were observed. Exercise enhanced fMRI was performed on 3 normal healthy subjects, fMRI with motor stimulation in 24 cases and fMRI with speech stimulation in 4 cases. The signal intensity increased in all cases responsing to both stimulations. But the signal intensity in 8 cases decreased in some regions by motor stimulation and 1 case by speech stimulation. The decrease of signal intensity in this study seems to be a clinically important finding and it will be required to examine the significance in future. (K.H.)