Buck Sarah, Bastos Filipa, Baldeweg Torsten, Vargha-Khadem Faraneh
Cognitive Neuroscience and Neuropsychiatry Section, Developmental Neurosciences Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, United Kingdom.
Great Ormond Street Hospital for Children National Health Service Trust, London, United Kingdom.
Front Neurol. 2020 Jan 10;10:1384. doi: 10.3389/fneur.2019.01384. eCollection 2019.
Functional Magnetic Resonance Imaging (fMRI) is a technique frequently used to determine the territories of eloquent tissue that serve critical functions, such as language. This can be particularly useful as part of the pre-surgical assessment for temporal lobe epilepsy (TLE) in order to predict cognitive outcome and guide surgical decision-making. Whereas language fMRI is widely used, memory fMRI is less frequently employed in adult TLE, and lacking in childhood TLE. We have developed a combined language/memory fMRI paradigm that is suitable for children, to provide clinically useful information for surgical planning in pediatric TLE. We evaluated this paradigm in 28 healthy children, aged 8 to 18 years. The advantages of this paradigm are: (a) it examines the functional mapping of language and memory networks within one scanning session, (b) provides assessment of both memory encoding- and retrieval-related neural networks, (c) examines recall-based retrieval to engage hippocampal involvement compared to recognition-based retrieval, and (d) provides overt verbal responses to monitor in-scanner memory performance. This novel fMRI paradigm was designed for language and memory mapping in pediatric TLE and could provide clinically useful information for surgical planning. Finally, parallel versions of the paradigm allow the comparison of brain activations pre- and post-surgical intervention.
功能磁共振成像（fMRI）是一种常用于确定执行关键功能（如语言功能）的明确脑组织区域的技术。作为颞叶癫痫（TLE）术前评估的一部分，这一技术可能特别有用，以便预测认知结果并指导手术决策。虽然语言功能磁共振成像被广泛使用，但记忆功能磁共振成像在成人TLE中较少应用，在儿童TLE中则更为缺乏。我们开发了一种适用于儿童的语言/记忆功能磁共振成像联合范式，为小儿TLE的手术规划提供临床有用信息。我们在28名8至18岁的健康儿童中评估了这一范式。该范式的优点包括：（a）在一次扫描过程中检查语言和记忆网络的功能映射；（b）对与记忆编码和检索相关的神经网络进行评估；（c）与基于识别的检索相比，检查基于回忆的检索以促使海马体参与；（d）提供公开的言语反应以监测扫描过程中的记忆表现。这种新型功能磁共振成像范式专为小儿TLE的语言和记忆映射而设计，可为手术规划提供临床有用信息。最后，该范式的并行版本允许比较手术干预前后的脑激活情况。
