Use of Resting State Functional MRI and functional NIRS for Language Localization in Presurgical Evaluation of Children with Drug Resistant Epilepsy
Abstract
Functional MRI (fMRI) is the only clinically available tool for non-invasive language mapping in children with drug-resistant epilepsy (DRE). Cooperation during the study is low; motion and network immaturity reduce reliability. A combined method with fNIRS, a lower-complexity technique, may cope with some limitations. We developed a combined approach using fNIRS and resting-state fMRI to map children with DRE.
We explored the application and limitations of fMRI and fNIRS in 33 children with DRE. In a subgroup of 12 patients, we conducted a pilot feasibility study to test the fNIRS-guided SEED-based analysis. A higher incidence of atypical language lateralization was observed in all methods. Discrepancies in task-specific lateralization were observed in some participants.
The fNIRS-fMRI combined approach is a novel technique to localize language networks in this population. It may increase accessibility and reliability of children to non-invasive techniques. Larger cohorts and invasive confirmation is needed to further validate this method.