Conclusions

There has been a tremendous recent increase in the options and techniques available for functional brain mapping. It is important that any clinicians who rely on the results of functional imaging studies be aware of the strengths and weakness of the various modalities. An important consideration is the fundamental differences between studies based on the disruption of neural activity (inactivation studies) and those that demonstrate brain activation related to a particular behavior (activation studies). Further considerations include the resolution (both spatial and temporal), reliability, validity, invasiveness, and repeatability of each method. There are now an unprecedented variety of choices in functional mapping modalities that can be used to augment, and in some cases replace, more conventional invasive procedures. Combining complementary modalities will minimize each method's weaknesses while maximizing the amount and quality of useful information available to the neurosurgeon. The continued development and refinement of functional brain mapping will provide the road map to allow the application of new minimally invasive therapeutic techniques.

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