School of Life and Health Sciences, Aston Brain Centre, Aston University, Aston Triangle, Birmingham, B4 7ET, UK.
School of Psychology, Faculty of Health, Deakin University, Burwood Campus, Deakin, VIC, Australia.
Brain Topogr. 2020 Mar;33(2):267-274. doi: 10.1007/s10548-019-00751-7. Epub 2019 Dec 21.
Functional magnetic resonance imaging (fMRI) is an established eloquent cortex mapping technique that is now an integral part of the pre-operative work-up in candidates for epilepsy surgery. Emerging evidence in adults with epilepsy suggests that material-specific fMRI paradigms can predict postoperative memory outcomes, however these paradigms are not suitable for children. In pediatric age, the use of memory fMRI paradigms designed for adults is complicated by the effect of developmental stages in cognitive maturation, the impairment experienced by some people with temporal lobe epilepsy (TLE) and the normal representation of memory function during development, which may differ from adults. We present a memory fMRI paradigm designed to activate mesial temporal lobe structures that is brief, independent of reading ability, and therefore a novel candidate for use in children. Data from 33 adults and 19 children (all healthy controls) show that the paradigm captures the expected leftward asymmetry of mesial temporal activation in adults. A more symmetrical pattern was observed in children, consistent with the progressive emergence of hemispheric specialisation across childhood. These data have important implications for the interpretation of presurgical memory fMRI in the pediatric setting. They also highlight the need to carefully consider the impact of cognitive development on fMRI tools used in clinical practice.
功能磁共振成像（fMRI）是一种成熟的语言皮质映射技术，现已成为癫痫手术候选者术前评估的重要组成部分。越来越多的证据表明，针对特定材料的 fMRI 范式可以预测术后记忆结果，但这些范式不适合儿童。在儿科人群中，由于认知成熟的发育阶段、某些颞叶癫痫（TLE）患者的认知障碍以及在发育过程中记忆功能的正常表现（与成年人不同），使用为成年人设计的记忆 fMRI 范式变得复杂。我们提出了一种记忆 fMRI 范式，旨在激活内侧颞叶结构，该范式简短，不依赖于阅读能力，因此是儿童使用的新候选者。来自 33 名成年人和 19 名儿童（均为健康对照）的数据表明，该范式在成年人中捕捉到了内侧颞叶激活的预期左偏性。在儿童中观察到更对称的模式，这与整个童年期间半球特化的逐渐出现一致。这些数据对儿科术前记忆 fMRI 的解释具有重要意义。它们还强调了在临床实践中使用 fMRI 工具时需要仔细考虑认知发展的影响。
