Pediatric Functional Magnetic Resonance Imaging (fMRI): Issues and Applications

Abstract

Functional magnetic resonance imaging (fMRI) represents a useful tool for studying brain functions and the neural basis of cognition in healthy children and in those in disease states. Functional magnetic resonance imaging is a relatively new use of existing magnetic resonance imaging technology that allows scientists and practitioners to observe the brain at work. It is based on the observation that local increases in blood flow are related to neural activity. This review considers principles of functional magnetic resonance imaging, issues relevant to imaging children, and research using functional magnetic resonance imaging to examine cognitive processing in pediatric populations. The focus is specifically on language studies to review strengths, limitations, and practical applications of this technology with children. Future directions for functional magnetic resonance imaging are presented.

FMRI language mapping in children: A panel of language tasks using visual and auditory stimulation without reading or metalinguistic requirements

“…From a clinical perspective, it is considered that fMRI may replace or serve as an important adjunct to the invasive intracarotid amobarbital (Wada test) or direct cortical stimulation mapping procedures, in order to delineate the eloquent cortex to be spared in children who are candidates for surgical resection (O'Shaughnessy et al, 2008). In line with studies showing the utility of presurgical fMRI language mapping in adults (Binder et al, 1996;Gaillard et al, 2002;Roux et al, 2003;Rutten et al, 2002;Tie et al, 2008Tie et al, , 2009, studies have reported the potential utility of this procedure in the even more crucial context of childhood (Anderson et al, 2006;Gaillard et al, 2000Gaillard et al, , 2001bHertz-Pannier et al, 1997;Holland et al, 2001;Wilke et al, 2005Wilke et al, , 2006.…”

“…In the context of pediatric fMRI, another major issue is that many language paradigms shown to be useful in adult studies are not well suited for children, and that child-specific tasks have to be specially designed (O'Shaughnessy et al, 2008;Wilke et al, 2003aWilke et al, , 2006. This may be even more problematic for children suffering from neurological or developmental disorders, especially language disorders.…”

“…For research purposes, fMRI allows to specify the normal functional development of the brain (Durston and Casey, 2006) and, particularly, the functional development of language during childhood (Holland et al, 2007;Sachs and Gaillard, 2003;Gaillard et al, 2006). One promising perspective is the investigation of the neural bases of developmental disorders, whose aetiology remains largely unknown Frith, 2006;O'Shaughnessy et al, 2008;Wilke et al, 2003a), including childhood developmental language disorders, (Dick et al, 2008;Friederici, 2006;Rapin et al, 2003).…”

“…Functional magnetic resonance imaging (fMRI) is a safe and noninvasive method for determining the brain functional localization and lateralization of language in children, which is an important issue both for pediatric clinical applications and research purposes (Gaillard et al, 2001a;O'Shaughnessy et al, 2008;Wilke et al, 2003a). From a clinical perspective, it is considered that fMRI may replace or serve as an important adjunct to the invasive intracarotid amobarbital (Wada test) or direct cortical stimulation mapping procedures, in order to delineate the eloquent cortex to be spared in children who are candidates for surgical resection (O'Shaughnessy et al, 2008).…”

Clinical functional MRI of the language domain in children with epilepsy

“…It should first be noted that there are specific aspects to performing fMRI studies in children. On one hand, fMRI even in healthy children already poses a number of special challenges: from a child-friendly task design and extensive subject preparation to pediatric particularities during data processing, great care must be taken to appropriately account for the special needs of children [O'Shaughnessy et al, 2008;Wilke et al, 2002Wilke et al, , 2008. This is all the more true for children with a neurological disorder like epilepsy: both the disorder itself and the necessary medication may influence the child's ability to cooperate [Yerys et al, 2009].…”