Functional MRIs for brain tumors and epilepsy
Functional magnetic resonance imaging, or fMRI, is a noninvasive way the VA can test brain responsiveness by measuring blood flow in the brain. It uses MRI technology to map where blood flows in the brain when the patient is asked to do different things, like finger tapping or object naming. fMRI can be used to gauge the effects of stroke, trauma, and degenerative disease on brain function, monitor tumors in the brain and spinal cord, and help in the planning of surgery or radiation therapy.
VA and fMRIs
fMRI could be an important diagnostic tool for veterans who will require surgery for brain tumors or epilepsy. fMRIs are able to map the areas affected by the tumors or lesions and can help to predict what memory and/or physical side effects may occur from the surgery based on the part of the brain where the surgery will be performed. For veterans who cannot receive radiation or radioactive tracers used in other radiology studies, MRIs, including the fMRI, could be used as an alternative diagnostic tool.
Are there issues with fMRIs?
There are a couple of major disadvantages to fMRIs and MRIs in general. First, the MRI machine is a giant, incredibly powerful magnet. So, if you have any non-MRI safe metal in their body, i.e. shrapnel (shrapnel wounds), they will likely not be allowed to have an MRI. It is important to note that modern implants and surgical materials, such as screws, plates, and pacemakers, should all be made of MRI safe materials, but the medical facility performing the MRI will need to clear any implants before the study can be performed. Another thing veterans may want to consult their doctor about before having an MRI is non-regulated tattoos that may contain metal in the ink. Although this does not automatically keep you from getting an MRI like shrapnel would, some patients experience a burning sensation in their non-regulated tattoos as the metal in the ink responds to the magnets of an MRI. Again, this does not exclude you from getting an MRI, but if you have enough tattoo ink containing metal, the discomfort could make it difficult for you to stay still during the MRI, which leads me to the second major disadvantage with MRIs.
MRI machines are highly sensitive to patient motion. For patients who have difficulty staying still for extended periods of time, have anxiety, or have claustrophobia, talk to your doctor before having an MRI done; anesthesia or anti-anxiety medication may be an option prior to having the MRI.
Important things to keep in mind
Lastly, the fMRI requires intravenous contrast to help enhance the images being produced. If you have kidney problems and/or allergies to intravenous contrast, you may not be a candidate for an fMRI. The medical facility will test your kidney function prior to performing the fMRI to make sure that your kidneys are functioning well enough for the contrast.
While there are a lot of things for your doctor to consider before ordering an fMRI with the VA, it is an increasingly popular diagnostic tool for mapping the brain. Additional information about fMRIs can be found: here, here, and here.
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