Presurgical Functional Localization Possibilities, Limitations, and Validity

Lydia Chougar, Delphine Leclercq, Pierre François Van de Moortele, Stéphane Lehéricy

Research output: Chapter in Book/Report/Conference proceedingChapter


Presurgical mapping using functional neuroimaging techniques—and particularly fMRI—is now commonly used in clinical practice and not just for research applications. Presurgical functional neuroimaging with its contributions to surgical planning and to the prediction of postoperative outcome is now well established. Validation studies of functional imaging techniques have shown the potential of fMRI to localize motor areas and to lateralize and localize language and memory functions. However, particularly for cognitive brain functions, the imaging results strongly depend on the methodology and require optimal clinical standard procedures. Currently, functional neuroimaging is considered complementary to direct electrical stimulation (DES) providing additional information, such as information on the entire functional network and on the contralateral hemisphere, which is not accessible to DES. Until now, fMRI cannot fully replace DES. In contrast, for language functions, and more recently, for memory functions, fMRI has supplanted the intracarotid amobarbital procedure (IAP) or Wada test. Diffusion tensor imaging (DTI) fiber tracking, which determines anatomical relationship between the tumor and adjacent fiber tracks, also plays a major role for presurgical mapping.

Original languageEnglish (US)
Title of host publicationMedical Radiology
PublisherSpringer Science and Business Media Deutschland GmbH
Number of pages30
StatePublished - 2022

Publication series

NameMedical Radiology
ISSN (Print)0942-5373
ISSN (Electronic)2197-4187

Bibliographical note

Publisher Copyright:
© 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.


  • Bold fMRI
  • Bold signal
  • Diffusion tensor imaging
  • Temporal lobe epilepsy
  • Transcranial magnetic stimulation


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