The Correlation Between FMRI And Direct Cortical Electrical Stimulation (DCES) In Motor Cortex Tumor Surgery: A Comparative Study

Object: To determine the reliabity of blood oxygen level dependent (BOLD) fMRI inlocating the primary motor cortex (M1) under pathological conditions caused by theproximity of a brain tumor. Methods:32patients with brain tumors in or adjacent to theM1were included in our study．BOLD-fMRI was performed preoperatively in eachpatient using a finger-tapping task. The image of M1was then delineated and mergedinto the navigation plan. During the operation, direct cortical electrical stimulation(DCES) was routinely performed to localize the M1. Sensitivity and specificity werecalculated according to electrical stimulation target.The fMRI and DCES consistencywas analyzed and evaluated. Results: In32cases of patients,action potential of thecontralateral hand was elicited in31patients(96.9%),1case(3.1%) was not elicited. Atotal of243cortical sites were tested with DCES, of which the TP128(52.7%), FP96(39.5%), TN10(4.1%), FN9(3.7%); overall functional MR imaging sensitivity andspecificity were93.4%and90.6%. There was no significant difference betweenBOLD-fMRI and DCES to locate the primary motor cortex (M1) in these patients(P＞0.05).Conclusion: BOLD-fMRI combined functional neuronavigation has acceptablevalidity to locate M1, comparing with DCES.