Functional MR imaging of language, memory, and sensorimotor cortex

Functional magnetic resonance imaging (fMR imaging) is employed to identify eloquent cortex to be spared during epilepsy surgery, principally the primary motor and sensory cortex, and brain areas implicated in language and memory. fMR imaging language paradigms have 90% concordance with intracarotid amobarbital tests (IAT) for identifying the dominant hemisphere for language; partial disparity occurs in 10% of patients; and overt discordance is rare but may occur under recognizable circumstances. The few studies to directly compare electrocortical stimulation with fMR imaging show a specificity of 67% and a sensitivity of over 90%. fMR imaging of memory paradigms demonstrate activation in mesial temporal structures but are not yet validated for individual patient surgical planning.