Advanced structural and functional MRI in childhood epilepsies

Area of Science:

• Neuroimaging
• Pediatric Neurology
• Epileptology

Background:

• Epileptic and developing brain networks in children are increasingly studied using advanced neuroimaging.
• Noninvasive techniques are crucial for assessing network organization and guiding treatment decisions.

Purpose of the Study:

• To review the evolving role of noninvasive MR imaging techniques in pediatric epilepsy and neurodevelopment.
• To highlight the application of DTI and fMRI in presurgical planning and network analysis.

Main Methods:

• Diffusion Tensor Imaging (DTI) for anatomical and microstructural connectivity.
• Functional MRI (fMRI) for motor and language network mapping.
• Comparison with invasive techniques and emerging applications like memory fMRI.

Main Results:

• DTI reveals microstructural changes in epileptic networks.
• fMRI provides precise motor mapping comparable to adults.
• fMRI for language dominance assessment reduces the need for invasive Wada tests in cooperative children.
• Memory fMRI is an emerging technique.

Conclusions:

• Noninvasive MR imaging significantly enhances the exploration of brain networks in pediatric epilepsy and development.
• fMRI is a valuable tool for presurgical planning, though invasive methods remain necessary for complex cases.