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  Acquisition of sensorimotor fMRI under general anaesthesia: Assessment of feasibility, the BOLD response and clinical utility

Yamato, A. K., Magerkurth, J., Mancini, L., White, M. J., Miserocchi, A., McEvoy, A. W., et al. (2019). Acquisition of sensorimotor fMRI under general anaesthesia: Assessment of feasibility, the BOLD response and clinical utility. NeuroImage: Clinical, 23: 101923. doi:10.1016/j.nicl.2019.101923.

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Item Permalink: http://hdl.handle.net/21.11116/0000-0004-6EE1-3 Version Permalink: http://hdl.handle.net/21.11116/0000-0004-6EE2-2
Genre: Journal Article

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 Creators:
Yamato, Adam Kenji1, 2, Author
Magerkurth, Jörg3, Author
Mancini, Laura1, 2, Author
White, Mark J.1, 4, Author
Miserocchi, Anna5, Author
McEvoy, Andrew W.5, Author
Appleby, Ian6, Author
Micallef, Caroline2, Author
Thornton, John S.1, 2, Author
Price, Cathy J.7, Author
Weiskopf, Nikolaus7, 8, Author              
Yousry, Tarek A.1, 2, Author
Affiliations:
1Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom, ou_persistent22              
2Lysholm Department of Neuroradiology, National Hospital for Neurology and Neurosurgery, London, United Kingdom, ou_persistent22              
3UCL Psychology and Language Sciences, Birkbeck-UCL Centre for Neuroimaging, London, United Kingdom, ou_persistent22              
4Medical Physics and Biomedical Engineering, University College London Hospital, London, United Kingdom, ou_persistent22              
5Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, London, United Kingdom, ou_persistent22              
6Department of Neuroanaesthesia, National Hospital for Neurology and Neurosurgery, London, United Kingdom, ou_persistent22              
7Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom, ou_persistent22              
8Department Neurophysics (Weiskopf), MPI for Human Cognitive and Brain Sciences, Max Planck Society, ou_2205649              

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Free keywords: fMRI; Anaesthesia; Brain tumour; Intra-operative; Neurosurgery
 Abstract: We evaluated whether task-related fMRI (functional magnetic resonance imaging) BOLD (blood oxygenation level dependent) activation could be acquired under conventional anaesthesia at a depth enabling neurosurgery in five patients with supratentorial gliomas. Within a 1.5 T MRI operating room immediately prior to neurosurgery, a passive finger flexion sensorimotor paradigm was performed on each hand with the patients awake, and then immediately after the induction and maintenance of combined sevoflurane and propofol general anaesthesia. The depth of surgical anaesthesia was measured and confirmed with an EEG-derived technique, the Bispectral Index (BIS). The magnitude of the task-related BOLD response and BOLD sensitivity under anaesthesia were determined. The fMRI data were assessed by three fMRI expert observers who rated each activation map for somatotopy and usefulness for radiological neurosurgical guidance. The mean magnitudes of the task-related BOLD response under a BIS measured depth of surgical general anaesthesia were 25% (tumour affected hemisphere) and 22% (tumour free hemisphere) of the respective awake values. BOLD sensitivity under anaesthesia ranged from 7% to 83% compared to the awake state. Despite these reductions, somatotopic BOLD activation was observed in the sensorimotor cortex in all ten data acquisitions surpassing statistical thresholds of at least p < 0.001uncorr. All ten fMRI activation datasets were scored to be useful for radiological neurosurgical guidance. Passive task-related sensorimotor fMRI acquired in neurosurgical patients under multi-pharmacological general anaesthesia is reproducible and yields clinically useful activation maps. These results demonstrate the feasibility of the technique and its potential value if applied intra-operatively. Additionally these methods may enable fMRI investigations in patients unable to perform or lie still for awake paradigms, such as young children, claustrophobic patients and those with movement disorders.

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Language(s): eng - English
 Dates: 2019-03-282019-01-162019-06-302019-07-02
 Publication Status: Published online
 Pages: -
 Publishing info: -
 Table of Contents: -
 Rev. Method: Peer
 Identifiers: DOI: 10.1016/j.nicl.2019.101923
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Funding organization : NIHR Biomedical Research Centre at University College London Hospitals NHS Foundation Trust and University College London

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Title: NeuroImage: Clinical
Source Genre: Journal
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Pages: - Volume / Issue: 23 Sequence Number: 101923 Start / End Page: - Identifier: ISSN: 2213-1582
CoNE: https://pure.mpg.de/cone/journals/resource/2213-1582