Background And Purpose: Resting-state fMRI (rs-fMRI) is increasingly used to map brain networks in patients under anesthesia, but technical factors can affect its utility. We evaluated the effects of sevoflurane, multiband acceleration, and scan duration on rs-fMRI signal quality and within-subject reliability under anesthesia.
Methods: We retrospectively analyzed 64 clinical rs-fMRI scans acquired under anesthesia, with or without sevoflurane and multiband factor 5 acceleration.
Introduction: Optimizing cognitive outcomes of pediatric epilepsy surgery requires understanding of risk for change in function, typically based on hemispheric lateralization of language skills. Identification of cognitive lateralization in children is complicated by disease in the setting of ongoing functional development. A quantitative method for assessing lateralization, the Cognitive Lateralization Rating Index (CLRI), was used as a systematic way to assess lateralized cognitive dysfunction in a sample of pediatric epilepsy surgery candidates.
View Article and Find Full Text PDFThe persistence of common, heritable conditions, like epilepsy, that are associated with reduced reproductive fitness is an evolutionary paradox. Endogenous analgesic, anti-depressant, and inflammatory mechanisms able to repair compromised functions can offer advantages in unexpected crises. Here, we challenge current thinking about the detrimental effects of seizures and epilepsy and suggest that (1) seizure-driven neuroplasticity might provide a protective mechanism, (2) seizure-induced neurotransmitter release not only helps to stop seizures but also increases resilience to pain, and (3) innate immune mechanisms triggered by recurrent seizures might neutralize novel viruses, like SARS-CoV-2, more rapidly, and so provided protection during the recent pandemic.
View Article and Find Full Text PDFObjective: Surgery is a standard treatment for medically refractory epilepsy, and many factors contribute to determining surgical approaches. The Cognitive Lateralization Rating Index (CLRI) quantifies the degree of dysfunction evident and can suggest atypical neuroanatomical functional organization if dominant skills remain despite left-hemisphere seizure foci (i.e.
View Article and Find Full Text PDFPediatric patients with epilepsy often have psychosocial and cognitive difficulties. Physical activity has emerged as a lifestyle modification that may reduce seizure burden, enhance brain plasticity, and improve cognitive and psychosocial comorbidities. We systematically reviewed published studies examining the effect of physical activity on cognitive and psychosocial function in children and adolescents with epilepsy.
View Article and Find Full Text PDFAJNR Am J Neuroradiol
February 2025
Background And Purpose: The quality of resting-state fMRI (rs-fMRI) under anesthesia is variable and there are no guidelines on optimal image acquisition or anesthesia protocol. We aim to identify the factors that may lead to compromised clinical rs-fMRI under anesthesia.
Materials And Methods: In this cross-sectional study, we analyzed clinical rs-fMRI data acquired under anesthesia from 2009-2023 at Massachusetts General Hospital.
Epilepsia
July 2024
Electrical stimulation mapping (ESM) is used to locate the brain areas supporting language directly within the human cortex to minimize the risk of functional decline following epilepsy surgery. ESM is completed by utilizing subdural grid or depth electrodes (stereo-electroencephalography [sEEG]) in combination with behavioral evaluation of language. Despite technological advances, there is no standardized method of assessing language during pediatric ESM.
View Article and Find Full Text PDFObjective: Improve data-driven research to inform clinical decision-making with pediatric epilepsy surgery patients by expanding the Pediatric Epilepsy Research Consortium Epilepsy Surgery (PERC-Surgery) Workgroup to include neuropsychological data. This article reports on the process and initial success of this effort and characterizes the cognitive functioning of the largest multi-site pediatric epilepsy surgery cohort in the United States.
Methods: Pediatric neuropsychologists from 18 institutions completed surveys regarding neuropsychological practice and the impact of involvement in the collaborative.
Child Neuropsychol
February 2023
Metamemory is a component of metacognition that includes both the knowledge of factors that affect memory (i.e. declarative metamemory) and knowledge and application of factors in one's own learning and recall performance (i.
View Article and Find Full Text PDFObjective: A broad spectrum of emotional-behavioral problems have been reported in pediatric temporal lobe epilepsy (TLE), but with considerable variability in their presence and nature of expression, which hampers precise identification and treatment. The present study aimed to empirically identify latent patterns or behavioral phenotypes and their correlates.
Methods: Data included parental ratings of emotional-behavioral status on the Behavior Assessment System for Children, 2nd Edition (BASC-2) of 81 children (mean age = 11.
Background And Objectives: Task fMRI is a clinical tool for language lateralization, but has limitations, and cannot provide information about network-level plasticity. Additional methods are needed to improve the precision of presurgical language mapping. We investigate language resting-state functional connectivity (RS fMRI; FC) in typically developing children (TD) and children with epilepsy.
View Article and Find Full Text PDFDevelopment of a task-free method for presurgical mapping of language function is important for use in young or cognitively impaired patients. Resting state connectivity fMRI (RS-fMRI) is a task-free method that may be used to identify cognitive networks. We developed a voxelwise RS-fMRI metric, Functional Connectivity Hemispheric Contrast (FC-HC), to map the language network and determine language laterality through comparison of within-hemispheric language network connections (Integration) to cross-hemispheric connections (Segregation).
View Article and Find Full Text PDFObjective: Right cerebellar-left frontal (RC-LF) white matter integrity (WMI) has been associated with working memory. However, prior studies have employed measures of working memory that include processing speed and attention. We examined the relationships between the RC-LF WMI and processing speed, attention, and working memory to clarify the relationship of RC-LF WMI with a specific cognitive function.
View Article and Find Full Text PDFIntroduction: In posterior fossa tumor survivors, lower white matter integrity (WMI) in the right cerebellar-left frontal pathway has been well documented and appears to be related to proximity to the cerebellum, radiation treatment, as well as time since treatment in both cranial radiation and surgery-only treatment groups. The current study investigated theories of transneural degeneration following cerebellar tumor resection that may underlie or relate to reductions in WMI and regional brain volumes using correlations. We hypothesized a positive relationship between the volume of the right cerebellum and known white matter output pathways, as well as with the volume of structures that receive cerebellar projections along the pathway.
View Article and Find Full Text PDFChild Neuropsychol
January 2019
Childhood brain tumors and related treatments disrupt the developing brain and have a cascading impact on core cognitive skills and intellectual (intelligence quotient [IQ]) and academic achievement outcomes. Theoretical models for this cascade have been developed based on the literature, but no studies thus far have empirically evaluated the models. The current study aimed to empirically test the two extant models and generate a new data-driven model of the relationships among neurodevelopmental risk factors, core cognitive skills (i.
View Article and Find Full Text PDFNeuropsychol Rev
September 2017
Due to medical advances, a large portion of children survive brain tumor diagnosis and treatment. Therefore, it is important to identify the neuroanatomical and neurocognitive outcomes associated with survivorship. This review summarizes the specific regional structural neuroimaging findings, the broad structural findings, as well as the corresponding neurocognitive domains affected in brain tumor populations.
View Article and Find Full Text PDFJ Int Neuropsychol Soc
May 2016
Objectives: The cerebellum (CB) is known for its role in supporting processing speed (PS) and cognitive efficiencies. The CB often sustains damage from treatment and resection in pediatric patients with posterior fossa tumors. Limited research suggests that CB atrophy may be associated with the radiation treatment experienced during childhood.
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