For years, scientists have been able to look at the living human brain to find tumors, aneurysms and other problems visible in a magnetic resonance image. But for the past decade, scientists have been able to see, not just what the brain looks like, but how it functions. Functional magnetic resonance imaging (fMRI) is revolutionizing the way scientists study how our brains work and what can go wrong. New studies will one day lead to faster, more accurate diagnoses for many types of brain disorders and diseases and to effectively treating them. The studies may even prove a biological basis for psychiatric disorders and abnormalities that so far have eluded scientists.

High-resolution functional MRI gives researchers the ability to observe our actual thought processes, and they are finding that the brain is more complex and adaptable than previously thought. “We have beautiful definition of the structure of the brain, conventionally, but now we can add to that a beautiful definition of the function of the brain,” says Joy Hirsch, Ph.D., director of the fMRI Research Center in the Department of Radiology at Columbia University (New York). “It gives us many more opportunities and advantages in practicing medicine than what we’ve had before.”

Clinical fMRI
Although much of the work with fMRI is being done by researchers studying how brains function and dysfunction, neurosurgeons also are turning to fMRI to help remove previously inoperable brain tumors. Because tumors often cause major structures of the brain to move, it is difficult for surgeons to know where those structures are in relation to the tumor. They often decide not to risk surgically removing the tumor for fear of damaging an important motor or sensory function, such as language.

By using fMRI to determine the location of those functions, surgeons reduce that risk. “When we can identify where the functional motor or language areas are, we can then assess the risk of a particular surgical procedure based on that information,” says Hirsch. “So not only can we assess risk ahead of time, but we can plan the surgical route so that the chance of morbidity is much reduced.”

Please refer to the January 2003 issue for the complete story. For information on article reprints, contact Martin St. Denis