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fMRI activation areas and intraoperative cortical mapping target in the precentral gyrus of 21 patients
Pain*Neurological StatusQuality of iCMfMRIComparison of iCM and fMRI
Hypoesthesia AllodyniaMotricityiCM Target Obtained†Limitations of iSEPLimitations of iBSfMRI Target Obtained†Analysis Threshold (P Values)‡Extent of fMRI Activation, Both Sides§Distance between Targets (mm)‖Concordance between Targets, Both Techniques
1/40/FFaceTN+NormalHand +Electrical artifactsElectrical artifactsHand +++<.0001Similar extent5Good: fMRI helped iCM targeting
Face 0Electrical artifactsElectrical artifactsFace not studied
2/62/MULScS++PlegicHand +++PlegicHand ++<.0001Healthy side > painful side3Excellent
3/65/FLLSS+PareticHand +++Hand +++<.0001Similar extent5Excellent
Foot ++Foot ++<.001Not studied8Good: fMRIhelped iCM targeting
4/44/MULScS++PlegicHand +++PlegicHand ++<.0001Healthy side > painful side3Excellent
5/33/FULScS+NormalHand +++Hand +++<.0001Similar extent3Excellent
6/66/FULScS+PareticHand +++Hand +++<.0001Similar extent4Excellent
7/34/MULPA+PlegicHand +Wave attenuationPlegicHand ++<.0001Healthy side > painful side5Good: fMRI helped iCM targeting
8/38/FFaceTN+NormalHand +++Hand +++<.0001Similar extent6Excellent
Face 0No waveNo responseFace not studied
9/70/MULSS+PareticHand +++Hand +++<.0001Similar extent3Excellent
10/65/FULPRP+++PlegicHand +Wave attenuationPlegicHand +++<.0001Similar extent3Good: fMRI helped iCM targeting
11/50/FFaceTN+NormalHand +++Hand +++<.0001Similar extent5Excellent
Face ++Diffused responseFace not studied5
12/73/MULA+++NoneHand +Wave attenuationAmputationHand +<.001Healthy side > painful side6Good: fMRI helped iCM targeting
13/70/MFaceTN+NormalHand +++Hand +++<.0001Similar extent3Excellent
Face 0Wave attenuationNot studiedFace not studied
14/40/MULA+++NoneHand +Wave attenuationAmputationHand +++<.0001Similar extent3Good: fMRI helped iCM targeting
15/54/FLLScS+PareticHand +Wave attenuationHand ++<.0001Similar extent3Good: fMRI helped iCM targeting
Foot 0No waveNot studiedFoot ++<.0001Not studied5Good: fMRI helped iCM targeting
16/56/FFaceTN+NormalHand +++Hand +<.01Not studied4Good: low fMRI significance
Face ++Face not studied
17/45/MFaceTN+++NormalHand +++Hand +++<.0001Similar extent3Excellent
Face 0No waveFace ++<.0001Not studied5Good: fMRI helped iCM targeting
18/66/FULScS+NormalHand +++Hand +++<.0001Similar extent1Excellent
FaceFace 0No waveNo responseFace ++<.001Not studied
19/59/FULScS++PareticHand +++Hand +++<.0001Similar extent3Excellent
FaceFace 0No waveNo resposneFace 0<.001
20/43/MULPA++PlegicHand +Wave attenuationPlegicHand +++<.0001Healthy side > painful side4Excellent
21/72/MULScS+PareticHand +++ArtifactsHand +++<.0001Similar extent5Excellent
LLFoot +Wave attenuationNo responseFoot ++<.0001Not studied
  • Note.—iCM indicates intraoperative epidural cortical brain mapping; fMRI, functional magnetic resonance imaging; iSEP, intraoperative somatosensory-evoked potentials; iBS, intraoperative epidural motor cortex bipolar stimulodetection.
  • * UL indicates upper limb; LL, lower limb; TN, trigeminal neuropathy; ScS, subcortical stroke; SS, spinal syrinx; PA, plexus avulsion; PRP, postradic plexopathy; A, amputation.
  • † Quality scales for iCM and fMRI targeting are: 0, no significant target; +, fair and ambiguous target; ++, unambiguous target altered by artifacts/wave attenuation; +++, unambiguous and precise target.
  • ‡ P values correspond to the analysis threshold of fMRI activation areas. Values less than .001 correspond to the initial analysis threshold; some targets remained significant for values less than .00001.
  • § Not studied indicates that comparisons between both sides were not studied because of alterations resulting from residual motion artifacts.
  • ‖ Distances reported between targets were measured intraoperatively by means of the neuronavigation microscope. They are purely indicative and do not reflect the resolution of fMRI and iCM.
  •  Excellent/good indicate important/partial overlap between fMRI target or unambiguous/ambiguous iCM target (note that ambiguous iCM targets impede correlations for both targets at more restrictive P values).