Identification of Hand Motor Area using Functional MRI for the Epilepsy Patients with Lesions around the Motor Area ? Comparison with the MEG and Intraoperative Functional Mapping-

[Objective] We evaluated the localization of motor function using functional MRI for the epilepsy patients with lesions around the motor strip. To evaluate the efficacy of F-MRI, we compared the localization of motor area between MRI, functional MRI, direct cortical stimulation, and Magnetoencephalography. [Method] Total 16 epilepsy patients were included in this study. Motor strip detection on MRI was performed based on the Iwasaki's method. F-MRI was performed using 1.5 tesler MRI, task of tapping fingers in each hand. The activated area was visualized over the MRI and compared with the results of other modalities. [Results] We divided the patients into two groups based on the identification of motor strip on MRI. Ten patients showed clear anatomical motor strip on MRI, in which nine exhibited single gyrus activation, concordant with the anatomical motor strip on MRI. Only one patient showed two gyri activation. Six patients showed unclear motor strip on MRI, in which 3 demonstrated single gyrus activation, concordant with the direct cortical stimulation results. Three patients presented two gyri activation, evolving true motor strip. Four patients underwent MEG examination, which showed concordant results with the cortical stimulation results. [Conclusions] F-MRI is useful for the preoperative motor area estimation, especially for the patients with clear central sulcus on MRI. If more than two gyri would be activated on functional MRI, further evaluations of MEG, as well as intraoperative functional mapping would be recommended to confirm the correct motor strip