Imaging the Impact of Childhood Epilepsy on Memory Development - Supplement

想象儿童癫痫对记忆发展的影响 - 补充

• 批准号: 10819051
• 负责人: Leigh Sepeta
• 金额: $ 10.69万
• 依托单位: CHILDREN'S RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-08-01 至 2024-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10819051
• 关键词: Adult; Affect; Anatomy; Biometry; Brain; Caring; Child; Childhood; Childhood Neurological Disorder; Clinical; Development; Doctor of Medicine; Doctor of Philosophy; Epilepsy; Evaluation; Excision; Functional Magnetic Resonance Imaging; Goals; Hippocampus; Image; Impairment; Knowledge; Language; Learning; Link; Magnetic Resonance Imaging; Maps; Measures; Medial; Memory; Memory impairment; Mentors; Mentorship; Methods; Neuropsychology; Operative Surgical Procedures; Outcome; Partial Epilepsies; Patients; Persons; Practice Guidelines; Principal Investigator; Protocols documentation; Research; Research Personnel; Research Training; Resolution; Rest; Risk; Seizures; Structure; System; Technology; Temporal Lobe; Temporal Lobe Epilepsy; Training; Training Programs; United States; childhood epilepsy; design; hippocampal subregions; improved; memory process; nervous system disorder; neural; neurodevelopment; neuroimaging; novel strategies; skills; success; verbal

PROJECT SUMMARY ABSTRACT Epilepsy affects 2.2 million adults in the United States, with 1 in 26 people developing epilepsy at some point in their lives. Temporal lobe epilepsy (TLE) is the most common form of focal epilepsy as medial structures, and the hippocampus in particular, are prone to generating seizures. Selective temporal resection is effective in curing TLE in 74-80% of patients, but puts patients at risk of impaired memory functioning. To minimize the adverse impact of temporal lobe surgery on memory functioning, reliable pre-surgical guides are needed. Clinical functional magnetic resonance imaging (fMRI) provides reliable, noninvasive guidance of language functioning in the pre-surgical evaluation for epilepsy patients. FMRI of memory is also emerging as a useful technology to predict adult outcomes and new AAN Practice Guidelines indicate moderate (Level B) evidence for verbal memory fMRI in predicting verbal memory outcome, based on adult studies. However, no memory fMRI studies exist in children with epilepsy. We will fill this gap by developing memory fMRI tasks that examine how the functional anatomy of memory systems across development is affected by pediatric TLE. Our novel approach links neuropsychological assessment with fMRI and MRI at standard and high-resolutions, and through resting-state connectivity to characterize the developmental neural underpinnings of memory. The aims of this proposal are to determine potential reorganization of memory function in children with TLE: 1) at the whole brain level, 2) within the hippocampus, and 3) via connectivity. This project will establish an fMRI protocol for the presurgical evaluation of memory in children with TLE. This protocol will improve surgical intervention by establishing the optimal timing of surgery based on when critical windows for reorganization occur. The Principal Investigator, Leigh Sepeta, PhD, is a neuropsychologist specializing in pediatric and adult epilepsy, with a focus on fMRI for language and memory mapping in epilepsy. She has a strong background in neurodevelopment, neuropsychology, and epilepsy. The proposed training plan will build upon her existing knowledge and promote three goals: 1) to acquire expertise in advanced neuroimaging methods, 2) to develop skills in high-resolution neuroimaging, hippocampal anatomy, and hippocampal subregion analysis, and 3) to advance skills in biostatistical analysis. Dr. Sepeta has assembled a strong mentorship and consultant team including William D. Gaillard, M.D., William H. Theodore, M.D., Chandan Y. Vaidya, PhD and Susan Y. Bookheimer, PhD (secondary mentor). Their expertise in pediatric and adult epilepsy, neuroimaging, hippocampal functioning, and neuropsychology are an ideal match for Dr. Sepeta's proposed research and training plans. The research-training program Dr. Sepeta has designed for this K23 proposal will further her overall goal of transitioning to an independent investigator focused on neuropsychological and neuroimaging evaluation of memory in neurological disorders, such as epilepsy.

项目摘要 在美国，癫痫影响着220万成年人，其中26人中有1人在2015年的某个时候患上癫痫。 孩子们当中.颞叶癫痫（TLE）是作为内侧结构的局灶性癫痫的最常见形式， 特别是海马体，容易产生癫痫。选择性颞叶切除是有效的， 在74-80%的患者中治愈TLE，但使患者面临记忆功能受损的风险。最小化 颞叶手术对记忆功能的不良影响，需要可靠的术前指导。 临床功能磁共振成像（fMRI）提供了可靠的，非侵入性的语言指导 在癫痫患者的术前评估中发挥作用。记忆的功能磁共振成像也是一种有用的 预测成人结局的技术和新的AAN实践指南显示中等（B级）证据 基于成人研究的非文字记忆功能磁共振成像预测非文字记忆结果。然而，没有记忆 fMRI研究存在于癫痫儿童中。我们将通过开发记忆功能磁共振成像任务来填补这一空白， 儿童TLE如何影响发育过程中记忆系统的功能解剖。我们的新型 方法将神经心理学评估与标准和高分辨率的fMRI和MRI联系起来， 通过静息态连接来描述记忆的发展神经基础。 本提案的目的是确定TLE儿童记忆功能的潜在重组：1） 在整个大脑水平上，2）在海马体内，以及3）通过连接。这个项目将建立一个功能磁共振成像 TLE患儿术前记忆评估方案该方案将改善外科手术 根据重组的关键窗口时间，通过确定手术的最佳时机进行干预 发生.主要研究者Leigh Sepeta博士是一名神经心理学家，专门研究儿童和成人 癫痫，重点是功能磁共振成像的语言和记忆映射癫痫。她有很强的背景， 神经发育、神经心理学和癫痫。拟议的培训计划将建立在她现有的 知识和促进三个目标：1）获得先进的神经影像学方法的专业知识，2）开发 高分辨率神经影像学、海马解剖学和海马亚区分析的技能，以及3） 提高生物统计分析技能。Sepeta博士组建了一个强大的导师和顾问团队 包括威廉·D医学博士盖拉尔，William H.医学博士西奥多，Chandan Y. Vaidya博士和Susan Y. Bookheimer博士（二级导师）。他们在儿童和成人癫痫，神经影像学， 海马功能和神经心理学是塞佩塔博士提出的研究的理想匹配， 培训计划。Sepeta博士为K23项目设计的研究培训计划将进一步促进她的研究。 总体目标是转变为专注于神经心理学和神经影像学的独立研究者 评估神经系统疾病的记忆力，如癫痫。