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Why are functional mris useful to doctors: Functional MRI (fMRI) of the brain

Functional MRI of the Brain > Fact Sheets > Yale Medicine


Before performing brain surgery to remove a tumor or abnormal brain tissue, doctors need to have the best possible picture of what is going on inside a patient’s head. 

That’s the role of functional magnetic resonance imaging (fMRI)—a procedure that’s often performed at Yale Medicine before invasive operations.

Using this technology, neuroradiologists share a patient’s image results with neurosurgeons, who can then determine which areas to target and which ones to avoid. It’s a noninvasive, pain-free test that can make surgery safer and more successful.

“There are space and time components to the imaging that help us find the parts of the brain that control motor function or language,” says William B. Zucconi, MD, a Yale Medicine neuroradiologist. “It’s almost like acquiring a little movie of the brain thinking.” 

What is functional magnetic resonance imaging (fMRI)?

When neuroradiologists perform an fMRI, they rely on the same scanner and interface used in magnetic resonance imaging (MRI). To obtain both types of imaging, a patient lies still in a long, tubular magnet, which uses the body’s magnetic properties to create highly detailed images. While an MRI scan allows doctors to examine a patient’s organs, tissue, or bones, “an fMRI looks at the function of the brain,” Dr. Zucconi explains.

When and why is fMRI performed?

Most fMRIs are usually performed soon after a diagnosis. The resulting images can help doctors and patients decide whether surgery is a good option. 

Typically, the scans are done 24 to 48 hours before a scheduled surgery. That way, surgeons have the most complete and accurate images just before the operation. fMRIs help neurosurgeons prepare for brain surgery, allowing them to successfully navigate to the correct region while they are in operating room.

How is an fMRI performed?

The procedure for a functional MRI is very similar to that of a regular MRI. The patient lies face-up on a flat surface and is rolled into a long tubular machine. The process is painless, although some people may feel claustrophobic or be bothered by the loud noises the machine makes during the scans.

Inside the scanner, patients are given instructions that are displayed digitally inside a pair of goggles—similar to a virtual reality (VR) headset. The tasks are simple, such as squeezing the left hand or thinking of certain words. The functional regions of the brain that light up in the scanner are then combined with regular MRI imaging of the patient’s brain anatomy. 

“Once we map out those basic functions, we help surgeons figure out a safe approach for removing a lesion or tumor from the brain—or for surgery for epilepsy patients,” Dr. Zucconi says. 

The main difference between the two procedures is that during an fMRI, doctors give the patient instructions and ask him or her to complete silent brain exercises while lying still.

The exercises increase activity in specific parts of the brain, increasing blood flow and oxygen to them. This activity lights up on the images created by the scanner, giving doctors a visible record of an exact map of the patient’s brain.

A normal MRI of the brain can last between 20 to 30 minutes, while the fMRI lasts between 40 to 55 minutes.  

What happens after an fMRI?

If a surgery is not scheduled immediately, patients may review the images with their doctors and decide how to proceed. If a tumor partially overlaps with the motor-skills or language center, for example, the patient may choose to only have part of it removed, or to treat the tumor with radiation instead of surgery.

What are the risks and benefits of fMRI?

An fMRI is safe, painless, and noninvasive. There are no known health risks associated with the procedure, as long as the patient has no metal or electronic implants (because the MRI machine has a very powerful magnet).

The benefits, on the other hand, are significant. Before the invention of fMRI, the only way to locate a person’s language or motor-skills center was to stimulate parts of the brain during an operation or perform invasive angiographic examinations—both of which required the patient to be awake to respond to questions. Knowing this information ahead of time makes surgery safer and faster, and the patient can stay under sedation during surgery.

What is unique about Yale’s approach to the fMRI procedure?

Neuroradiologists at Yale Medicine work closely with surgeons, oncologists, and neurologists with specialized knowledge about treating brain tumors and disorders of all types. 

“Our ongoing research studies rely on fMRI to better understand various diseases, including psychiatric conditions like depression, as well as Tourette syndrome and epilepsy,” Dr. Zucconi says.

Another area of active research relies on resting state fMRIs. These work as the name suggests, by imaging the brain while it is at rest. “This type of imaging gives insight into the brain’s networks and interconnected regions,” Dr. Zucconi says. 

What Is fMRI? Uses, How It Works, Duration, and What to Expect

When you’re taking a test or enjoying a cup of coffee, certain parts of your brain are extra busy. An fMRI allows us to capture some of this activity.

Functional resonance imaging (fMRI) has revolutionized the study of the mind. This advanced neuroimaging technology allows researchers and physicians to safely, painlessly, and noninvasively observe the brain’s activity.

An fMRI scan can be used for a variety of purposes, from monitoring Parkinson’s disease to seeing how a certain medication works in the brain.

If you’re scheduled for an fMRI, understanding what it is and how it works can help you feel more comfortable.

Invented in the early 1990s, functional magnetic resonance imaging (fMRI) is a type of noninvasive brain imaging technology that detects brain activity by measuring changes in blood flow.

An fMRI can reveal what part of the brain is active during specific functions, such as lifting your arm or even just thinking about something. Researchers and physicians can use this information to better understand, diagnose, monitor, and treat various conditions.

An fMRI is based on the same technology as magnetic resonance imaging (MRI) — a scanning tool that uses powerful magnetism and radio waves to produce images of the body. However, there are important differences between the two.

An MRI takes images of your brain’s structure — it can see cysts, tumors, bruising, bleeding, and structural abnormalities.

When you get an MRI scan, the scan is looking to make sure everything is the right size or is in the right place. For instance, are there any signs of damage, such as bruising? If so, there might be a concussion.

In contrast, an fMRI takes images of your brain’s activity while it’s performing a particular function. It can even “see” your thoughts and feelings. An fMRI is essentially creating a functional map on top of the brain images.

During an fMRI scan, you might be asked to perform a task, like lift your arm or think of the word “summer.” These tasks activate your brain so the fMRI can measure your brain’s activity.

Other times, you might be asked to just relax in the scanner — this is known as a resting state (rs) fMRI. An rs- fMRI helps define both typical and atypical brain connectivity in a variety of conditions.

An fMRI uses a powerful magnetic field — tens of thousands of times stronger than the Earth’s magnetic field — to detect activity in different parts of the brain.

What does it mean when a brain area is “more active?” And how does the fMRI detect this activity?

A brain area is considered more active when its neurons start sending out more electrical signals than they did before. For instance, if a certain brain area is more “active” when you raise your leg, then that part of the brain is considered responsible for that movement.

An fMRI indirectly measures this electrical activity by detecting changes in oxygen levels in the blood. This is called the blood-oxygen-level-dependent (BOLD) response.

Here’s how this works:

When neurons become more active, they require more oxygen from red blood cells. To achieve this, they widen the surrounding blood vessels to allow for more blood flow. Thus, when the neurons are more active, the oxygen concentration goes up, too.

Oxygenated blood produces fewer field disturbances than deoxygenated blood which allows the neurons’ signal (which is actually hydrogen in water) to last longer. So when the signal stays longer, the fMRI knows that there’s more oxygen in that area, and therefore more activity.

This activity is color-coded in the resulting fMRI images.

fMRIs are used widely in both clinical and research settings. This technology allows us to better understand how the brain works in both healthy and diseased conditions.

In clinical practice, most fMRIs are performed soon after a diagnosis. The resulting brain images can help your healthcare team decide on a treatment plan and whether surgery might be a good option.

An fMRI scan is also commonly given right before brain surgery to help the neurosurgeon prepare.

An fMRI can be used to:

  • diagnose conditions
  • plan for a surgery or other treatments
  • detect abnormalities
  • see which brain regions are responsible for important functions
  • evaluate the cognitive effects of diseases and injuries, such as epilepsy, concussion, or cancer
  • determine drug efficacy
  • help with drug development
  • understand brain disorders
  • examine how memories are formed
  • observe how the brain handles critical functions like thinking, emotional responses, learning, movement, sensation, or speech (called brain mapping)
  • look for disease biomarkers
  • monitor therapy

An fMRI might also be used to detect the following:

  • epilepsy
  • concussion
  • post-concussion syndrome
  • mental illnesses, such as schizophrenia
  • neurological conditions, such as Alzheimer’s disease and Parkinson’s disease
  • tumors
  • pain

fMRI is often used to study healthy brains as well. In a small-scale 2015 study on eight participants, researchers used fMRI to examine brain function during risky decision-making. The participants had to decide between taking a risky or safe gamble based on their chances of winning (high or low).

In the first experiment, the participants were told their chances of winning at the same time they were given the chance to gamble. In a second experiment, the chance was presented before the gambling opportunity.

The findings show that when the participants knew the odds prior to the gambling opportunity (and kept this information in mind), they had more control of their risk-taking behaviors. This was shown by brain activation in regions associated with control and conflict. The participants showed faster reaction times and better performance.

An fMRI unit involves a flat table that slides into a large cylinder-shaped tube surrounded by a circular magnet. “Open” fMRI machines are open on the sides.

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A typical fMRI lasts between 45 and 55 minutes.

Before your fMRI, you’ll get instructions on how to prepare and what to expect.

Before the scan

There are no major preparations before an fMRI scan, as there are no injections or invasive procedures.

However, you’ll need to remove your phone, jewelry, glasses, coins, or anything metal (these belongings will likely be put into a safe locker). Medication patches may also need to be removed as the metal in the patch could heat up during the fMRI scan. Keep another one on hand to apply after the procedure.

Any medical implants or devices (such as a stent) may have to be removed prior to the fMRI scan as well.

If you are pregnant or have any health problems, allergies, problems with lying on your back, or claustrophobia (fear of confined spaces), talk with your doctor to help you come up with a plan.

During the scan

During the fMRI scan, you will lie face-up on a flat scanning table that’s rolled into a long, tubular magnet. You may be given instructions, such as squeezing your right hand or thinking of certain words. These activities are color-coded on the brain images, allowing the doctor to see a map of your brain activity.

The process is painless, but some people may feel bothered by the small space or loud noises the machine makes. A typical fMRI lasts between 40 and 55 minutes.

After the scan

Once your fMRI scan is complete, the technologist will slide the scanning table out of the machine and help you up. You can collect your belongings and leave the scanning area. Your doctor will receive a report of your fMRI results which will be used to plan your care.

Before the fMRI was invented, the only way to identify the brain’s motor or language skills center was to stimulate the brain during an invasive procedure, such as surgery. With fMRI, we now have a safe, painless, and noninvasive way to see brain activity.

If you’d like more information, there are plenty of online sites and videos explaining fMRI. This video gives a detailed description of how fMRI works.

Mental device: in Russia they learned to detect depression by MRI | Articles

Russian scientists have developed a method for diagnosing clinical depression based on magnetic resonance imaging. The effectiveness of the new approach was confirmed by trials involving 84 patients . It allows you to identify severe emotional disorders with an accuracy of 93%. The method is based on the analysis of connections in the brain, which, as studies have shown, differ in sick and healthy people. According to practicing psychotherapists, MRI diagnostics of depression can be useful for specialists, but should only be used as an additional tool.

How do you like it, Dr. Freud?

Specialists of the Baltic Center for Neurotechnologies and Artificial Intelligence of the IKBFU I. Kanta, together with colleagues from Plovdiv University and Ural Federal University , developed an objective method for diagnosing major depressive disorder (MDD) using magnetic resonance imaging. It allows you to detect the disease with an accuracy of 93%. An MRI brain image is analyzed by artificial intelligence . Experts trained him to identify differences in neural connections between healthy and sick people. The effectiveness of the approach has been successfully confirmed in the course of work with real patients. The experiments involved 49 healthy people and 35 patients with clinical depression .

We can classify both short-range connections between neighboring areas, and distant ones, which already determine the nature of the entire structure of connections in the brain of healthy and sick people . The proposed classifier achieves an accuracy of 93%,” Alexander Khramov, chief researcher at the Baltic Center for Neurotechnologies and Artificial Intelligence, told Izvestia.

Photo: Getty Images/Johner Images

Izvestia reference

Major depressive disorder is a severe emotional state that is accompanied by low mood, loss of interest in life and the ability to enjoy life, cognitive decline, as well as insomnia, appetite disorders and other symptoms . According to WHO, there are now 280 million patients with this diagnosis. They often require medical treatment. Now the disease is detected based on the opinion of specialists: neurologists, psychiatrists and psychotherapists. However, all over the world there is a search for objective markers of MDD for its more reliable diagnosis.

Study used functional magnetic resonance imaging to study how the brain works in healthy and sick people. Functional MRI records the blood flow in the organ, which can be used to judge the activity of certain of its zones. The analysis showed that in people with MDD there is a weakening of the connections between individual areas of the brain . At the final stage of study , IKBFU specialists trained a neural network to find this feature in specific images of patients and determine whether a person is healthy or sick . Diagnostic examination on MRI takes no more than 15 minutes . It can be performed on most standard tomographs that are used in clinics and hospitals.

The developers plan to continue their research to find changes in the brain that occur in patients with bipolar disorder (BAD). In terms of symptoms, this disorder resembles MDD, which often leads to diagnostic errors. This is a serious medical problem because depression and bipolar disorder are treated differently . If scientists succeed, then the neural network will be able to distinguish one from the other. Another challenge faced by specialists is to determine exactly by what criteria the program diagnoses depression . The peculiarity of AI is that its logic is not fully known to users. This will allow you to control the quality of the neural network.

Secondary instrument

MRI diagnosis of depression can be only one of the ways to determine the disease, but not the main one , says psychologist, psychotherapist, candidate of psychological sciences Sofya Sulim. Any professional psychotherapist in his work should be guided by an understanding of pathopsychological causes . If a person has evidence, then he should be referred to a psychiatrist. An MRI study should only be considered as an additional tool when making a decision .

Photo: Getty Images/IAN HOOTON/SPL

— The diagnosis of emotional disorders in psychotherapy is associated with the analysis of certain cognitive functions: memory, attention, imagination, thinking. The specialist must see them. For example, a person’s lack or decrease in criticality, misunderstanding of the meaning of sayings is manifested. A with the help of an MRI study, it is impossible to find out what a psychotherapist can learn from practice, so these are useful, but only secondary tools , – noted Sofya Sulim.

The proposed approach looks promising for confirming and objectifying the diagnosis in MDD , says Dmitry Petelin, a psychiatrist at the Clinic for Psychosomatic Medicine of Sechenov University. According to him, a qualified specialist accurately identifies depression by clinical symptoms. But such techniques are useful to be sure of the diagnosis . However, the problem is the high cost of such an examination .

— At the same time, there are difficult cases when an objective assessment is necessary. It is often difficult for clinicians to distinguish between clinical depression and depression associated with bipolar disorder. For such a distinction, an MRI study will be in demand by doctors , the specialist is sure.

Russian medicine requires the development of its own decision support software system based on the work of AI, and products such as classifiers that analyze MRI data can become part of them , says Olga Valaeva, head of the SPC “Virtual Clinic” of the Moscow Institute of Psychoanalysis, clinical psychologist.

The study was carried out within the framework of the strategic project “Puzzle” of the IKBFU. I. Kant under the program of the Ministry of Education and Science of Russia “Priority 2030”.

Functional MRI in Moscow – the best prices for an MRI examination.

22 May 2018 Diagnosis Headache, Dizziness, Buzzing in the ears, Diagnosis, Weakness, Noise in the head

The effectiveness of the treatment of the disease depends on the stage at which it is started – the sooner, the better and faster the result will be. A neglected disease can give more serious consequences even if procedures are being carried out to eliminate it. As for the brain, it is very difficult to identify the initial stages of pathologies here, because. they are not visible from the outside. For this, functional MRI is used – an indispensable tool in surgery and neurology.

Functional MRI of the brain: how is it different from conventional diagnostics?

The functional type of tomography differs from the classical one in that the indicators are taken not in a calm state, but in the process of active brain activity.

During exercise, brain cells are better saturated with oxygen, the total blood flow increases. This is picked up by the tomograph scanner. Registration of activity occurs due to an increase in tissue magnetization – it depends on the additional oxidation of glucose.

The stronger signal is compared with the values ​​obtained in normal, quiet mode. A specialist with the help of a computer program overlays one three-dimensional image on another.

Signals from different cortical and subcortical structures are registered and differentiated:

  • Basal ganglia.
  • Belt bark.
  • Thalamus.
  • All types of tumors – not only their size and contours, but also the degree of penetration into the gray and white medulla.

Functional MRI can compare the behavior of brain cells:

  • At rest.
  • During mental work.
  • During physical, motor activity.

Functional type of tomography makes it possible to accurately determine the location and size of all brain centers:

  • Sensory.
  • Motor.
  • Speech and others

If a more precise examination is required, the patient is given additional glucose.

Features of functional MRI diagnostics

Options for using the results of functional tomography:

  • Surgery. Before brain surgery, an exact action plan is drawn up using a tomographic map – it clearly shows the damage that needs to be repaired. This avoids errors in actions and complications.
  • Radiology. Tomographic data make it possible to calculate the amount of radiation needed to treat cancer.
  • Neuropsychology. The study of failures in the work of memory, speech apparatus, attention.
  • Identification of epileptic foci.
  • Ischemic areas are visible at an early stage – to prevent stroke.
  • Recognition of the initial processes of Alzheimer’s and Parkinson’s diseases.
  • The method allows you to find a connection between brain activity and dizziness, noise shift in from one ear to another.

A radiation specialist can fully decipher the data obtained as a result of the study.

When you can not do a functional MRI

Since a powerful magnet is involved in the case and it is necessary to lie quietly for an hour, being inside a cylindrical device, there are contraindications:

  • Early pregnancy.
  • Claustrophobia.
  • Metal parts inside the body and on the body – implants and prostheses that cannot be removed.
  • Psychiatric disorders, due to which the patient cannot be immobile for at least thirty minutes.

Tattoos with a metal component, small fillings and any non-magnetic materials are not dangerous, but you need to warn the doctor about them in order to compensate for the deviations of the magnetic field caused by these objects and, accordingly, data distortion.

The research technique has undoubted advantages:

  • High quality brain map.
  • Image resolution – more than three millimeters.
  • A convenient way to study the brain in a calm and active state.
  • No harm to the body – the procedure does not lead to cell death and other negative consequences.
  • Availability of the method – for this you do not need to go abroad.
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