"催眠态"与"气功态"脑运动皮质低频活动差异的初步研究

目的:研究催眠态和气功态下脑运动皮质的低频同步活动,探讨催眠态与气功态对脑功能皮质活动的不同效应。材料和方法:研究对象为1例28岁的健康女性志愿者,右利手。采用气功入静和催眠诱导分别进入气功态和催眠态。研究采用GEsigna VH/i3.0T磁共振扫描机,先后进行无任务(静息态、催眠态和气功态)和运动任务的BOLD序列扫描。图像的处理先以运动任务获得的运动皮质定位作为种子对三种状态的功能图像做交互相关分析,获得脑功能连接的激活图,然后对这些激活的体素采用功率谱分析,获得相应的优势频率和能量。结果:脑功能低频连接激活体素的数量在静息态、催眠态、气功态间没有明显差异,但通过功率谱分析,催眠态主要表现为优势频率能量的升高,而气功态则主要表现为优势频率的增加。结论:气功态和催眠态下脑运动皮质的低频活动存在一定的差异,提示两种状态有通过不同的途径产生效应,但其生理基础有待于进一步研究。     

Stroop效应在冥想训练研究中的应用

目的:通过Stroop实验探讨冥想训练的神经心理学效应.方法:采用经典Stroop字色判断任务,通过e-prime2软件对4名志愿者和4名气功师进行间隔半小时的两次实验,记录被试字色判断任务的准确性和反应时间.fMRI实验采用组块设计,数据分析采用SPM8软件,对志愿者和气功师在脑内激活情况进行比较.结果:志愿者字色判断干扰任务的平均准确率略低于气功师,平均反应时较气功师为长.气功师和志愿者间fMRI实验的脑内激活存在差异,差异区域主要在左侧前额叶背外侧皮质(DLPFC)、前扣带皮质(ACC)和顶下小叶(IPL).结论:Stroop实验可以作为一种客观的手段来评价气功练习者的冲突控制能力,长期的气功练习可以提高练习者冲突控制的能力.     

气功入静时前扣带回自发低频活动变化的fMRI研究

目的:采用功能磁共振成像技术研究在气功入静过程中大脑前扣带回的低频信号变化,探讨前扣带回在气功活动中的潜在调节机制。材料和方法:研究对象为练功20年以上,以静功为主的气功师6位。研究采用GE Signa VH/i 3.0T磁共振扫描机,EPI-BOLD序列。在入静前、入静早期、入静后期和结束入静后分4次进行静息fMRI扫描。图像处理采用AFNI软件,计算大脑前扣带回频率在0.01～0.8Hz间的低频活动功率谱的优势频率和平均振幅。对不同入静状态时这两个指标的差异进行比较和分析。结果:大脑前扣带回在入静时的优势频率(0.0167Hz)要高于入静前和结束入静后(0.0125Hz);功率谱的平均振幅在入静早期最高,而在入静后期有所下降,仍高于入静前和结束入静后。结论:前扣带回在不同入静状态时低频活动的动态变化,提示它在人静过程中起着重要的调节作用。低频活动的功率谱可以作为气功入静状态的一个潜在指标。     

静息态fMRI确定双手运动相关脑区——种子点选择对结果的影响

目的 探讨种子点的选择对静息态fMRI确定双手运动相关脑区的影响.方法 对31例（男15例,女16例）健康被试者行组块设计的双手运动和静息态fMRI扫描.采用DPARSF V2.0软件和SPM8软件进行数据处理,选取任务状态下各独立激活簇的最大激活点为种子点,分别计算静息状态下全脑功能连接图,计算静息状态下各功能连接图与任务状态激活图之间的空间相关系数.结果 任务状态下得到15个独立的激活脑区,进而生成15个种子点,其中辅助运动区（SMA）为种子点的功能连接图与任务状态激活图空间分布一致性最强,空间相关系数最大;以初级运动皮质（M1区）及背侧前运动皮质（PMd）为种子点的功能连接图包括双侧M1区及SMA;以腹侧前运动皮质（PMv）为种子点所得功能连接图主要为PMv和PMd;以壳核（Pu）、丘脑（Th）、小脑前叶（CbAL）、小脑后叶（CbPL）为种子点所得功能连接图主要为种子点周围及其镜像脑区.结论 静息状态下,以SMA为种子点能获得与手运动任务激活图有较好一致性的功能连接图,以M1及PMd为种子点能较好显示M1区.     

ALS患者运动皮层区的静息态功能磁共振成像分数低频振幅研究

目的 应用静息态功能磁共振成像(rs-fMRI)分数低频振幅(fALFF)方法对肌萎缩侧索硬化(ALS)患者运动皮层区基线脑活动变化进行研究. 方法 使用Siemens Trio Tim 3.0 T MRI对ALS组和正常对照组(各12例)分别进行静息态fMRI扫描.静息态fMRI数据处理助手(DPARSF)基于Matlab 2009a平台进行数据预处理并计算fALFF值,使用WFU PickAtlas软件提取运动皮层区[布鲁德曼(BA)4区和BA6区],应用静息态fMRI数据处理助手(REST)两样本t检验比较两组运动皮层区fALFF的改变.并分析运动皮质区存在显著差异脑区的fALFF值与临床参数如肌萎缩侧索硬化功能等级量表(ALSFRS-r)、病程、疾病预后比值的相关性.结果 相对正常对照组,ALS患者皮质运动区fALFF值降低区域主要位于双侧中央前回、双侧辅助运动区(P＜ 0.05,AlphaSim校正);相对于正常对照组,ALS患者皮质运动区fALFF值升高区域主要位于左侧中央前回、左侧辅助运动区、左侧旁中央小叶(P＜ 0.05,AlphaSim校正).其中左侧中央前回和患者的ALSFRS-r呈正相关(r=0.605,P=0.037);左侧旁中央小叶和患者的ALSFRS-r呈负相关(r=-0.633,P=0.027).差异脑区fALFF值和疾病病程、疾病预后比值之间并无显著的相关性(P值范围分别是0.154 ～0.968,0.303 ～0.995).结论 ALS患者存在运动皮质区神经元活动的异常,左侧中央前回fALFF值减低、左侧旁中央小叶fALFF值增高或可作为ALS患者疾病严重程度的潜在定量标志之一.表明fALFF是定量观测ALS运动皮质功能改变的一个有用指标.     

静息态fMRI确定双手运动相关脑区——种子点选择对结果的影响

目的探讨种子点的选择对静息态fMRI确定双手运动相关脑区的影响。方法对31例(男15例,女16例)健康被试者行组块设计的双手运动和静息态fMRI扫描。采用DPARSFV2.0软件和SPM8软件进行数据处理,选取任务状态下各独立激活簇的最大激活点为种子点,分别计算静息状态下全脑功能连接图,计算静息状态下各功能连接图与任务状态激活图之间的空间相关系数。结果任务状态下得到15个独立的激活脑区,进而生成15个种子点,其中辅助运动区(SMA)为种子点的功能连接图与任务状态激活图空间分布一致性最强,空间相关系数最大;以初级运动皮质(M1区)及背侧前运动皮质(PMd)为种子点的功能连接图包括双侧M1区及SMA;以腹侧前运动皮质(PMv)为种子点所得功能连接图主要为PMv和PMd;以壳核(Pu)、丘脑(Th)、小脑前叶(CbAL)、小脑后叶(CbPL)为种子点所得功能连接图主要为种子点周围及其镜像脑区。结论静息状态下,以SMA为种子点能获得与手运动任务激活图有较好一致性的功能连接图,以M1及PMd为种子点能较好显示M1区。     

选择反应和选择心算时脑电相干谱的反应特点

为了解不同脑区之间各频率脑电活动的同步性特点及其在认知活动中的变化 ,对2 0名正常被试者在安静及对数字声音信号进行选择反应和选择心算时 9个脑区之间的相干幅谱进行了比较研究。结果 :在进行选择反应作业时 ,额及中央脑区的左右脑之间低频活动 (δ ,θ和α)相干幅值显著增大 ,而后脑区左右脑之间高频活动 ( 2 0～ 70Hz)的相干幅值显著减小 ,与选择反应比 ,选择心算时的主要变化表现为后脑区左右脑之间θ活动和高频活动相干幅值的增大。上述结果表明 ,在进行认知活动时 ,左、右脑相应结构之间的同步联系显著增强且主要是通过低频脑电活动 ,而前、后脑区的不同结构之间则主要表现为脱同步。     

简单型书写痉挛患者异常皮质活动的功能磁共振成像研究

目的:利用功能磁共振成像,研究简单型书写痉挛患者的皮质异常功能活动,探讨其病因基础。材料和方法:分别对10名简单型书写痉挛患者和10名健康右利手志愿者进行手指写、执笔写任务期间的功能磁共振成像。使用AFNI软件,对数据经过预处理及反卷积分析等处理,获得患者组和正常组两个任务的平均脑激活图并进行比较。结果:与正常组之间相比较,患者组初级感觉运动区和辅助运动区表现为与执笔写任务相关的更明显的激活,而双侧的后顶叶皮质激活在两个不同任务期间均较正常减弱。结论:简单型书写痉挛患者存在运动和感觉皮质的异常活动,反映了其运动皮质的去抑制和感觉处理过程的障碍,并且感觉处理过程的异常可能在其病因过程中起重要作用。     

杨氏太极拳习练者静息状态下比率低频振幅及工作记忆特征

目的:研究杨氏太极拳练习对老年人大脑静息状态下比率低频振幅(fALFF)的改变情况,为进一步阐明运动延缓认知脑老化的机制提供理论支持。方法:招募太极拳组老年人20例与步行组老年人22例,采集被试者颅脑静息态磁共振数据,采用2-back任务测定太极拳组和步行组的反应时、正确率。对太极拳组和步行组的全脑的比率低频振幅(fALFF)磁共振数据进行独立样本t检验,并进行AlphaSim校正,确定最小体素数量。提取具有组间差异的脑区的fALFF值与任务测定结果做Pearson相关分析。结果:在0.01～0.08 Hz频段,左侧额中回的fALFF值太极拳组大于步行组,同时太极拳组的左侧额中回fALFF值与工作记忆刷新任务2-back的反应时存在统计学的相关性(r=0.576,P=0.007),而在步行组间没有明显的相关性。结论:太极拳组存在静息态下与工作记忆相关的左侧额中回活动增强,推测太极拳可能通过改善工作记忆功能进而延缓老年人认知功能衰退。     

书写痉挛脑功能成像磁共振研究

目的：利用功能磁共振成像,研究书写痉挛患者皮质异常功能活动,探讨其病因。方法：分别对10名书写痉挛患者和10名健康志愿者进行书写任务期间的功能磁共振成像,对数据经过分析处理,获得患者组和正常对照组两个任务的平均脑激活图并进行比较。结果：与正常对照组相比较,患者组初级感觉运动区和辅助运动区表现为与书写任务相关的明显激活,而双侧的后顶叶皮质激活在两个不同任务期间均较正常减弱。结论：书写痉挛患者存在运动和感觉皮质的异常活动,反应了其运动皮质的去抑制和感觉处理过程的障碍,并且感觉处理过程的异常可能在其病因过程中起重要作用。     

海洛因依赖者前额叶皮层与海马温度改变的磁共振波谱测量

目的 探讨磁共振波谱(MRS)技术测量海洛因依赖者前额叶皮层与海马温度变化的可行性及意义.方法 对18例处于戒断治疗期的海洛因依赖者和18例健康志愿者(对照组)分别于静息态和视觉刺激(呈现海洛因相关图片)诱导渴求状态下进行单体素MRS扫描,测量前额叶皮质和双侧海马N-乙酰基天门冬氨酸(NAA)化学位移值,通过修正后的温度-NAA化学位移方程,计算其脑温度.结果 海洛因依赖组静息态前额叶皮层脑温度较对照组上升,差异有统计学意义(P<0.05),并且其脑温度值与吸食总量呈正相关(P<0.05);但比较静息态与视觉刺激态前额叶皮层及海马温度无显著统计学差异(P>0.05).结论 MRS可无创性测量脑温度,脑温度的异常改变有助于探讨药物成瘾与渴求机制.     

Mapping functionally related regions of brain with functional connectivity MR imaging

BACKGROUND AND PURPOSE: In subjects who are performing no prescribed cognitive task, functional connectivity mapped with MR imaging (fcMRI) shows regions with synchronous fluctuations of cerebral blood flow. When specific tasks are performed, functional MR imaging (fMRI) can map locations in which regional cerebral blood flow increases synchronously with the performance of the task. We tested the hypothesis that fcMRI maps, based on the synchrony of low-frequency blood flow fluctuations, identify brain regions that show activation on fMRI maps of sensorimotor, visual, language, and auditory tasks. METHODS: In four volunteers, task-activation fMRI and functional connectivity (resting-state) fcMRI data were acquired. A small region of interest (in an area that showed maximal task activation) was chosen, and the correlation coefficient of the corresponding resting-state signal with the signal of all other voxels in the resting data set was calculated. The correlation coefficient was decomposed into frequency components and its distribution determined for each fcMRI map. The fcMRI maps were compared with the fMRI maps. RESULTS: For each task, fcMRI maps based on one to four seed voxel(s) produced clusters of voxels in regions of eloquent cortex. For each fMRI map a closely corresponding fcMRI map was obtained. The frequencies that predominated in the cross-correlation coefficients for the functionally related regions were below 0.1 Hz. CONCLUSION: Functionally related brain regions can be identified by means of their synchronous slow fluctuations in signal intensity. Such blood flow synchrony can be detected in sensorimotor areas, expressive and receptive language regions, and the visual cortex by fcMRI. Regions identified by the slow synchronous fluctuations are similar to those activated by motor, language, or visual tasks.     

周围性面瘫患者的静息态脑功能成像分析

目的:探讨周围性面瘫患者静息态脑功能成像(fMRI)功能连接变化。方法:研究对象分为2组,面瘫组16例,为左侧周围性面瘫患者;对照组39例,为健康志愿者。所有受试者均采用相同的MRI扫描序列采集静息态功能数据,并利用AFNI程序进行脑功能连接分析。功能连接分析共选择双侧后扣带回(PCC)、左侧面部初级感觉皮层(LSⅠ)、右侧面部初级感觉皮层(RSⅠ)、左侧面部初级运动皮层(LMⅠ)、右侧面部初级运动皮层(RMⅠ)5个区域为感兴趣区(种子点)。采用单样本t检验(P<0.001)进行功能连接的组内分析和两样本t检验(P<0.01)进行组间分析,所有的分析结果均采用MonteCarlo方法进行多重比较校正。结果:周围性面瘫组和对照组的组内分析结果显示,双侧PCC、LSⅠ、RSⅠ、LMⅠ和RMⅠ均与多个脑区(大脑、小脑、丘脑以及基底节区等灰质区域)存在着广泛性的功能连接;组间分析结果显示2组间PCC、RSⅠ、RMⅠ的功能连接没有差异;周围性面瘫组较健康志愿者组LSⅠ、LMⅠ的功能连接2组间存在差异。LSⅠ的组间分析显示,LSⅠ与双侧扣带回、楔前叶、左侧楔叶、枕上回及枕中回的功能连接增强;LMⅠ的组间分析显示,LMⅠ与双侧扣带回、楔前叶、右侧额中回、额下回、中央前回、颞上回、颞中回、颞横回、顶下小叶、枕中回、角回、尾状核、苍白球、丘脑、岛叶及左侧枕上回等脑区的功能连接增强。结论:左侧周围性面瘫患者的静息态脑功能网络变化主要表现为同侧大脑半球面部初级感觉皮层和面部初级运动皮层与相关脑区的功能连接增强。功能连接增强的脑区主要分布于感觉相关脑区和运动相关脑区,推测可能与面瘫患者面部运动感觉障碍的脑功能代偿作用有关。     

Alzheimer Disease: evaluation of a functional MR imaging index as a marker

PURPOSE: To measure changes in functional synchrony in the hippocampus in patients with mild cognitive impairment (MCI) and Alzheimer disease (AD). MATERIALS AND METHODS: Three subject groups (nine cognitively healthy elderly control subjects, 10 patients with probable AD, and five subjects with MCI) underwent resting-state functional magnetic resonance (MR) imaging for measurement of functional synchrony in the hippocampus. Functional synchrony was defined and quantified as the mean of the cross-correlation coefficients of spontaneous low frequency (COSLOF) components between possible pairs of voxel time courses in a brain region, or the COSLOF index. The two-tailed Student t test was used to determine differences in the COSLOF index between the control group, the probable AD group, and the MCI group. An operating characteristic curve was calculated to graphically depict the tradeoff between sensitivity and specificity of the COSLOF index. RESULTS: Functional synchrony quantified with the COSLOF index was obtained in AD, MCI, and control subjects. COSLOF index values were significantly lower in AD patients than in control subjects (t = 4.32, P <.0012). For MCI subjects, COSLOF index values were significantly higher than those of AD patients (t = -2.4052, P <.047) but significantly lower than those of control subjects (t = 2.257, P <.043). The exponential-class curve significantly fits the relationship between the COSLOF index and the Mini-Mental Status Examination score (chi(2) = 20.4), indicating the rapid decrease in cognitive capacity below a threshold of the COSLOF index. CONCLUSION: Our results suggest that the COSLOF index could be used as a noninvasive quantitative marker for the preclinical stage of AD.     

利用fMRI研究正常人执行Stroop任务的脑功能网络

目的:利用功能磁共振成像(fMRI)探讨正常人执行汉字Stroop任务时任务相关的激活与去激活脑功能网络。方法:14例正常志愿者接受了Stroop任务的组块式fMRI,扫描序列为平面回波血氧水平依赖(BOLD)序列,利用统计参数图(SPM99)软件进行图像分析。所有检查完毕后,对受试者进行Stroop的行为学测试,记录反应时间及错误数。结果:正常对照组认字试验的反应时间与颜色命名试验之间差异有显著性意义(t=-8.188,P=0.000)。对照状态下,正常人出现后扣带回皮层、中线前额叶皮层、背侧前扣带回的去激活。正常人执行颜色命名任务较认字任务时出现更多脑区的激活,且其激活强度较第1个任务的脑区激活强度增加。执行颜色命名任务时动用了双侧额中回、左侧额上回、左侧额下回及双侧顶叶。结论:本研究进一步证实静息状态下存在大量的神经元活动,其与任务相关的脑功能网络共同维持正常的认知活动。     

IVIM扩散加权成像对多发性肌炎和皮肌炎的诊断价值

目的：探讨体素内不相干运动扩散加权成像（IVIM-DWI）技术在多发性肌炎和皮肌炎中的诊断价值。方法：对10例经肌肉活检证实的多发性肌炎和皮肌炎患者（病患组）及11例健康志愿者（正常对照组）进行双侧大腿轴位T1 WI、T2 STIR 和 IVIM-DWI 扫描,经后处理分析和测量得到 IVIM 参数值：快速弥散系数（ADCfast 值）、慢速弥散系数（ADCslow 值）、快速弥散分数（Ff 值）。采用单因素方差分析比较各组间参数值差异。结果：病患组水肿肌肉、未受累肌肉（T2 STIR 上未显示水肿）及正常对照组正常肌肉 ADCslow 分别（1．59±0．26）、（1．41±0．24）、（1．34±0．13）×10－3 mm2／s,差异有统计学意义（P ＜0．05）,各组 ADCfast 分别为（10．83±2．69）、（9．09±1．55）、（7．48±2．73）×10－3 mm2／s,差异有统计学意义（P ＜0．05）,其中病患组未受累肌肉 ADCfast 值高于正常肌肉,差异有统计学意义（P ＜0．05）。各组 Ff 值差异无统计学意义（P ＞0．05）。结论：IVIM-DWI 技术可用于定量评估肌肉水分子扩散及微血管灌注情况,ADCslow 和 ADCfast 值对多发性肌炎和皮肌炎的诊断具有重要作用,其中 ADCfast 值对其早期诊断有意义。     

不同动机特质在静息态下脑功能相关研究

目的?动机特质包括趋近系统（BAS）和行为抑制系统（BIS）,利用静息态功能MRI研究不同动机特质的被试在静息态下大脑活动的差别,以及与默认网络（DMN）、背侧注意网络（DAN）和额顶控制网络（FPN）之间功能连接强度的相关性。方法? 将38例完成BIS/BAS问卷的健康在校女大学生分为3组：高BAS低BIS组（高BAS组）,高BIS低BAS组（高BIS组）,低BAS低BIS组（对照组）。采集静息态fMRI及结构像数据并进行预处理及统计。计算低频振幅（ALFF）值,将高BAS组及高BIS组分别与对照组比较,利用双样本t检验的统计学方法,得出显著差异的脑区。利用种子相关分析法获得3个脑网络并获得其间的功能连接强度,将功能连接强度同每个被试BAS、BIS得分进行Spearman相关分析。结果? 两实验组与对照组比较,ALFF值呈显著性增高的脑区分别为：高BAS组主要位于左侧距状回、左侧楔前叶、后扣带回皮质、右侧尾状核、两侧前扣带回皮质、左侧额中回;高BIS组主要位于右侧顶下小叶、额叶、颞叶、距状回及左侧后扣带回。ALFF值呈显著性减低的脑区分别为：高BAS组主要位于两侧丘脑、右侧颞上回及左侧顶叶;高BIS组主要位于左侧顶叶、额叶及两侧前扣带回。BAS分值与DMN-FPN、DAN-FPN功能连接强度呈显著相关（r=0.69,P＜0.001;?r=-0.40,P=0.037）;BIS分值与DMN-DAN功能连接强度呈显著相关（r=-0.41,P=0.036）。?结论? 静息态下不同动机特质呈现前额叶偏侧化活动。动机特质与网络间功能连接强度存在一定相关性。动机特质是多个脑区组成的网络水平负载的神经活动。     

Repeatability of functional MRI for conformal avoidance radiotherapy planning

PURPOSE: To establish the repeatability of functional magnetic resonance imaging (fMRI) examinations in order to develop an appropriate margin for functional organs at risk (fOAR) in the radiotherapy planning process. MATERIALS AND METHODS: This work investigates the variability of motor cortex activation in the left and right hemispheres of 15 normal subjects. The uncertainty of the absolute position and volume of the activation was determined for each volunteer by repeating the fMRI examination three times in a single scan session. RESULTS: Our study proposes the use of 2.9 mm and 2.2 mm margins for the left and right motor cortices, respectively. CONCLUSION: From the sample of 15 volunteers we established an appropriate planning margin that is considered to represent the uncertainty in spatially measuring the fOAR for a single fMRI examination. The work will be of interest to anyone investigating the clinical robustness of fMRI.     

Real-Time Motor Cortex Mapping for the Safe Resection of Glioma: An Intraoperative Resting-State fMRI Study

BACKGROUND AND PURPOSE:Resting-state functional MR imaging has been used for motor mapping in presurgical planning but never used intraoperatively. This study aimed to investigate the feasibility of applying intraoperative resting-state functional MR imaging for the safe resection of gliomas using real-time motor cortex mapping during an operation.MATERIALS AND METHODS:Using interventional MR imaging, we conducted preoperative and intraoperative resting-state intrinsic functional connectivity analyses of the motor cortex in 30 patients with brain tumors. Factors that may influence intraoperative imaging quality, including anesthesia type (general or awake anesthesia) and tumor cavity (filled with normal saline or not), were studied to investigate image quality. Additionally, direct cortical stimulation was used to validate the accuracy of intraoperative resting-state fMRI in mapping the motor cortex.RESULTS:Preoperative and intraoperative resting-state fMRI scans were acquired for all patients. Fourteen patients who successfully completed both sufficient intraoperative resting-state fMRI and direct cortical stimulation were used for further analysis of sensitivity and specificity. Compared with those subjected to direct cortical stimulation, the sensitivity and specificity of intraoperative resting-state fMRI in localizing the motor area were 61.7% and 93.7%, respectively. The image quality of intraoperative resting-state fMRI was better when the tumor cavity was filled with normal saline (P = .049). However, no significant difference between the anesthesia types was observed (P = .102).CONCLUSIONS:This study demonstrates the feasibility of using intraoperative resting-state fMRI for real-time localization of functional areas during a neurologic operation. The findings suggest that using intraoperative resting-state fMRI can avoid the risk of intraoperative seizures due to direct cortical stimulation and may provide neurosurgeons with valuable information to facilitate the safe resection of gliomas.

Mapping the motor cortex before and during tumor resection is of great importance to minimize the risks of postoperative neurologic sequelae. Direct cortical stimulation (DCS) is an invasive procedure to locate the function of specific brain regions. Due to its simplicity, DCS is considered the clinical criterion standard for mapping brain function and has demonstrated efficacy in optimizing glioma resection.^1,2 However, as an invasive approach, DCS requires a surgical team with rich experience. DCS also has the risk of after discharges, which can induce seizures and result in the inaccurate localization of cortical areas.³Blood oxygen level–dependent (BOLD) functional MR imaging, a task-based brain functional mapping method, has been well-established for localizing the brain functional area for presurgical planning. BOLD fMRI is of great importance in helping decrease morbidity due to a neurologic operation⁴ and has been integrated into neuronavigation systems to localize the motor area during an operation.⁵ Nonetheless, brain shifting during an operation might reduce the accuracy of preoperative imaging and affect the clinical consequences.⁶The emergence of intraoperative MR imaging (iMRI) has ushered in a new era in brain tumor neurosurgery.⁷ Real-time structural imaging and diffusion tensor imaging have provided neurosurgeons with valuable information regarding whether and where tumor residues persist after resection and even the relationship between the tumor/tumor cavity and peritumoral tracts.^8,9 The use of an iMRI navigation system can reliably compensate for the effects of brain shifting.⁶ We have recently reported intraoperative motor mapping with fMRI for the first time; in this procedure, awake intraoperative fMRI was used to localize the sensorimotor areas during awake craniotomy.¹⁰ Cooperation of the patient under specific tasks and complicated surgical procedures is essential for successful mapping. Therefore, task-induced brain mapping cannot be achieved with the patient under general anesthesia.Resting-state fMRI (R-fMRI) has recently been used to identify the motor cortex without a task stimulus.¹¹ This technique has been used in preoperative motor mapping in patients with brain tumors.^12–14 Our previous study demonstrated the accuracy of preoperative R-fMRI (pR-fMRI) for motor area localization by DCS before tumor resection.¹³ However, the study was based on pR-fMRI and lacked real-time information regarding the relationship between the tumor cavity/residual and the motor cortex, which might have affected the conclusion of whether further resection is safe.To our knowledge, functional connectivity based on intraoperative resting-state fMRI (iR-fMRI) has not been applied to real-time motor cortex mapping during an operation. The purpose of this study was to investigate the feasibility and validity of applying iR-fMRI to neurosurgical mapping. The sensitivity and specificity of iR-fMRI in mapping the motor cortex were assessed and compared with those of DCS. The optimum iR-fMRI protocol for better intraoperative imaging quality was also studied.