"fMRI of Language in Brain Tumor Patients: A Window to Understanding Cortical Plasticity"

Andrei I. Holodny, M.D., Chief of the Neuroradiology Service, Director of the Functional MRI Laboratory, Department of Radiology, Memorial Sloan-Kettering Cancer Center Professor of Radiology, Weill Medical College of Cornell University Pre-operative functional MRI (fMRI) has become an invaluable tool in the localization of essential brain areas that are to be avoided during resection of central nervous system malignancies. In the course of clinical work, our group has uncovered cases of neurosurgically proven cortical reorganization (plasticity) in patients with brain tumors. Cortical reorganization appears to afford a behavioral advantage to patients with left-hemispheric tumors. Patients with fMRI evidence for plasticity performed significantly better on clinical measures of aphasia compared to their left-lateralized counterparts. Models of cortical connectivity, based on graph theoretical models of networks by our group (Morone, Nature 2015) have demonstrated how new connectivity arises in the setting of cortical plasticity. We have also addressed the problem of the effect of neurovascular uncoupling in causing false negative results in both task based and resting-state fMRI and have come up with math models based on independent physiological parameters to overcome this issue.