Development of a Natural Viewing Paradigm for fMRI Language Mapping for Brain Tumor Surgery Planning

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Yanmei Tie, PhD

Brain tumor surgery aims to maximize tumor resection (removal); however, it must weigh and minimize the risk of resection-induced neurological deficits. Preventing injury to language areas is especially important as it can lead to potential lifelong language deficits (known as aphasia). This naturally has an enormous impact on quality of life. Mapping out the language function areas in individual patients poses a challenge due to the high complexity and variability of the brain language network location from patient to patient.

As a clinical non-invasive imaging technique, functional MRI is used to identify language areas by measuring blood oxygen level-dependent (BOLD) signal change while patients perform language tasks (such as generation of antonyms). In short, specific areas of the brain “light up” under MRI when the patient performs basic language tasks.

Although task-based fMRI has been widely used to aid surgical planning, it has shortcomings. First, it requires adequate task performance, which excludes many patients who have difficulty performing language tasks due to neurological deficits (such as aphasia and attention problems). Second, due to the complex language function and patient-specific conditions, a panel of tasks is needed. This requires expertise to design and administer the tasks which are time and cost consuming.

To overcome the limitations of task-based fMRI, Dr. Tie aims to develop a novel fMRI protocol and a corresponding analytic strategy for mapping individual patients’ language areas. This protocol is less demanding, therefore allowing fMRI language mapping for more patients, especially those who cannot perform traditional language tasks. It is also easier for the technologists to administer, and has the potential to provide a comprehensive map of the complex language network, therefore reducing the time and cost of pre-surgical planning. Dr. Tie will collaborate with Dr. Alexandra Golby and Dr. Srinivasan Mukundan, Jr., in the proposed project.