J Korean Neurosurg Soc.  2013 Dec;54(6):453-460. 10.3340/jkns.2013.54.6.453.

Changes of Motor Deactivation Regions in Patients with Intracranial Lesions

• Lee SH
• Koh JS
• Ryu CW
• Jahng GH

• KMID: 2190939
• DOI: http://doi.org/10.3340/jkns.2013.54.6.453

Abstract

OBJECTIVE
There is a rich literature confirming the default mode network found compatible with task-induced deactivation regions in normal subjects, but few investigations of alterations of the motor deactivation in patients with intracranial lesions. Therefore, we hypothesized that an intracranial lesion results in abnormal changes in a task-induced deactivation region compared with default mode network, and these changes are associated with specific attributes of allocated regions.
METHODS
Blood oxygenation level dependent (BOLD) functional magnetic resonance imaging (fMRI) during a motor task were obtained from 27 intracranial lesion patients (mean age, 57.3 years; range 15-78 years) who had various kinds of brain tumors. The BOLD fMRI data for each patient were evaluated to obtain activation or deactivation regions. The distinctive deactivation regions from intracranial lesion patients were evaluated by comparing to the literature reports.
RESULTS
There were additive deactivated regions according to intracranial lesions: fusiform gyrus in cavernous hemangioma; lateral occipital gyrus in meningioma; crus cerebri in hemangiopericytoma; globus pallidus, lateral occipital gyrus, caudate nucleus, fusiform gyrus, lingual gyrus, claustrum, substantia nigra, subthalamic nucleus in GBM; fusiform gyrus in metastatic brain tumors.
CONCLUSION
There is increasing interest in human brain function using fMRI. The authors report the brain function migrations and changes that occur in patients with intracranial lesions.

Keyword

Default mode; Functional MRI; Motor task; Deactivation; Intracranial lesion

MeSH Terms

Basal Ganglia
Brain
Brain Neoplasms
Caudate Nucleus
Globus Pallidus
Hemangioma, Cavernous
Hemangiopericytoma
Humans
Magnetic Resonance Imaging
Meningioma
Oxygen
Substantia Nigra
Subthalamic Nucleus
Oxygen

Figure

• 

  Fig. 1 Map of motor task-induced activation differences in patient with cavernous hemangioma. Voxels showing significant brain activation during left hand motor task shown in yellow. Voxels showing significantly reduced activation for the same task shown in light-blue. Deactivations were observed in prefrontal cortex, posterior cingulated, precuneus, and postcentral gyrus.

• 

  Fig. 2 Functional magnetic resonance imagings (fMRI) of the patients with intracranial lesions during motor task revealed additive task-induced deactivated regions. The case number is in the left lower corner of each patient's image. Distinctive deactivated regions are marked with arrowhead.

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  Fig. 3 MRI and fMRI in a 56-year-old woman with glioblastoma (case 7). A: T1-weighted MRI with gadolinium demonstrating a large, well enhanced mass with central necrosis in the right middle frontal gyrus, which is compatible with gliobalstoma. B: Axial fMRI series during left hand motor task showing activation (orange) and deactivation (light-blue) regions. Arrowhead denote the distinctive deactivated regions.

• 

  Fig. 4 MR imaging studies in a 53-year-old man with hemangiopericytoma (case 4). A: T1-weighted MRI with gadolinium demonstrating well enhanced lobulating mass adhering to sagittal sinus in left frontoparietal lobe. B: Axial fMRI series during right hand motor task showing activation (orange) and deactivation (light-blue) regions. Note that distinctive deactivated region in the right crus cerebri in midbrain (arrowhead).

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