Magnetic source imaging demonstrates altered cortical distribution of function in patients with arteriovenous malformations

G. Edward Vates, Michael T. Lawton, Charles B. Wilson, Michael W. McDermott, Van V. Halbach, Timothy P L Roberts, Howard A. Rowley, Juha Jääskeläinen, Juha Hernesniemi, Jyrki Mäkelä, Nobuhiro Mikuni, Nobuo Hashimoto, Shahram Partovi, Robert F. Spetzler, Richard E. Latchaw, Oliver Ganslandt, Rudolf Fahlbusch

Research output: Contribution to journalArticle

29 Scopus citations

Abstract

OBJECTIVE: Arteriovenous malformations (AVMs) can be treated successfully, but treatment can pose unacceptable risks if the AVM is located in eloquent cortex. Because AVMs are developmental lesions, the location of primary cortical function may be deranged. We used magnetic source imaging (MSI) to identify the central sulcus and to determine whether primary cortical function was shifted in a set of 30 patients. We correlated these findings with outcome after treatment. METHODS: We retrospectively analyzed the clinical data of 30 patients with AVMs who underwent MSI. Nonparametric statistical comparisons were made to correlate the proximity of AVMs to primary cortex and somatosensory shift to outcome at 12 months. RESULTS: Using MSI, 14 patients (47%) were found to have AVMs involving primary cortex, and 10 patients (33%) were found to have shift in the somatosensory homunculus. Primary cortical involvement was neither required nor sufficient to cause shift (Mann-Whitney U test, z = -0.02, P = 0.31). Patients with AVMs involving primary cortex fared worse after treatment than did patients with AVMs that spared primary cortex (Mann-Whitney U test, z = -2.3, P = 0.02). The presence or absence of shift did not correlate with outcome after treatment (Mann-Whitney U test, z = -0.18, P = 0.48). CONCLUSION: MSI showed that some patients with AVMs have abnormal cortical distribution of function. The involvement of primary cortex correlated with worse outcome after treatment. Our results suggest that preoperative functional imaging may help to better estimate treatment risks and ultimately to guide therapeutic planning.

Original languageEnglish (US)
Pages (from-to)614-627
Number of pages14
JournalNeurosurgery
Volume51
Issue number3
DOIs
StatePublished - Sep 1 2002

Keywords

  • Arteriovenous malformation
  • Brain plasticity
  • Magnetic source imaging
  • Presurgical planning

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

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    Vates, G. E., Lawton, M. T., Wilson, C. B., McDermott, M. W., Halbach, V. V., Roberts, T. P. L., Rowley, H. A., Jääskeläinen, J., Hernesniemi, J., Mäkelä, J., Mikuni, N., Hashimoto, N., Partovi, S., Spetzler, R. F., Latchaw, R. E., Ganslandt, O., & Fahlbusch, R. (2002). Magnetic source imaging demonstrates altered cortical distribution of function in patients with arteriovenous malformations. Neurosurgery, 51(3), 614-627. https://doi.org/10.1097/00006123-200209000-00005