To find out information about the impact of brain tumors onto the blood oxygen level dependent (BOLD) signal functional magnetic resonance imaging in the motor cortex area was performed with finger tapping in 22 patients and 18 healthy controls. An a priori VOI based method was developed that allows quantifying the mean BOLD signal amplitude and the extent of activated volume. In patients additionally the following parameters were collected and were correlated with the asymmetry of the functional activation: Blood volume in the tumor, type of tumor, size and distance of the tumor and its surrounding edema and the compression of the central sulcus.
The new method proved to be able to quantify the functional activation. The evaluation revealed a significantly bigger activated volume of the left versus right hemisphere motor area in the control group. In the tumor group the activated volume and the mean signal amplitude ipsilateral was reduced. No difference was found between the activation of the central region of the healthy hemisphere of cancer patients and the central activation of healthy subjects. The mean signal amplitude shows a significant inverse correlation with the fractional blood volume in the tumor. Moreover, there was a greater reduction of activation when the motor cortex lies within the edema and a smaller area was activated, the stronger the central sulcus was compressed. The size of the tumor or of the surrounding edema and the distance of the tumor from the motor cortex were not related to the impairment of the BOLD activation.
Thus, brain tumors seem to influence the BOLD effect due to a combination of different factors, particularly by hemodynamic changes and by force on the central region in case of mass effect or increased tissue pressure.
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