Functional Magnetic Resonance Imaging in Preoperative Brain Mapping
Summary
Functional Magnetic Resonance Imaging (fMRI) has become an indispensable tool in the presurgical evaluation of patients with intracranial lesions by non-invasively mapping brain functions that must be preserved during resection. It relies on the blood-oxygen-level dependent (BOLD) signal to infer neuronal activity and can be delivered through task-based paradigms—where patients perform motor, language or sensory tasks—or via resting-state protocols that map intrinsic functional connectivity without active participation. Through improvements in magnetic field strength, sequence design and computational modelling, spatial resolution now approaches sub-millimetre precision, while advanced noise-reduction techniques mitigate motion and physiological artefacts. By co-registering functional maps with structural MRI and intraoperative guidance systems, including direct electrical stimulation, surgeons can tailor resection margins to maximise tumour removal and minimise postoperative deficits. Despite challenges such as neurovascular uncoupling near pathology and variability in analysis workflows, ongoing standardisation efforts and multimodal validation studies are broadening the clinical adoption of fMRI for individualised neurosurgical planning worldwide.
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Functional Magnetic Resonance Imaging in Preoperative Brain Mapping publication trend
The graph below shows the total number of articles in functional magnetic resonance imaging in preoperative brain mapping across all publications each year (not limited to Nature Index journals).
Technical terms
Blood-oxygen-level dependent (BOLD) signal: Change in MR signal due to variations in blood oxygenation reflecting neural activity.
Task-based fMRI: Imaging protocol in which subjects perform specific tasks to elicit functional activation in targeted brain regions.
Resting-state fMRI: Imaging protocol capturing spontaneous neural activity through low-frequency fluctuations in the BOLD signal while subjects are at rest.
Direct electrical stimulation: Intraoperative technique applying electrical pulses to delineate functional areas by observing induced responses.
Ultrahigh-field MRI: MRI systems operating at magnetic field strengths of 7 tesla or above, providing increased spatial resolution and sensitivity.
References
- A comparison of fMRI presurgical mapping techniques with intraoperative brain mapping-based validation. Imaging Neuroscience (2024).
- 7 T and beyond: toward a synergy between fMRI-based presurgical mapping at ultrahigh magnetic fields, AI, and robotic neurosurgery. European Radiology Experimental (2024).
- Challenges and techniques for presurgical brain mapping with functional MRI. NeuroImage Clinical (2017).
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