Fredrik Brekke: Standardizing Auditory and Visual fMRI Paradigms

Functional MRI (fMRI) is a vital tool for presurgical planning, yet it faces challenges due to a lack of methodological standardization. At the 2025 fMRI User Meeting, Fredrik Brekke shared insights from a systematic review of over 100 peer-reviewed studies, revealing significant variations in how sensory paradigms are designed and analyzed. Key Research Insights:. Methodological Diversity: Studies targeting the same brain regions or functions often use widely different paradigm structures, stimuli, and analysis pipelines. This diversity complicates the comparison of findings across different institutions., Clinical Implications: Inconsistent approaches can lead to brain activation maps that vary due to methodology rather than neurobiology. For neurosurgery, it is critical that paradigms are robust, sensitive, and reproducible across different scanners and patient populations., The Need for Best Practices: Rather than a "one-size-fits-all" stimulus, the field needs standardized approaches to paradigm decisions and open reporting of protocols., Multisensory Approaches: The use of multiple or multisensory paradigms is recommended to provide a more holistic and reliable mapping of pre-operative brain functions. Moving Forward: Achieving methodological clarity and transparency is essential for fMRI to deliver truly individualized and clinically meaningful insights, bridging the gap between basic research and routine clinical use.