Imaging the Impact of Childhood Epilepsy on Memory Development

想象儿童癫痫对记忆发展的影响

基本信息

批准号：
9906938
负责人：
Leigh Sepeta
金额：
$ 16.21万
依托单位：
CHILDREN'S RESEARCH INSTITUTE
依托单位国家：
美国
项目类别：
财政年份：
2018
资助国家：
美国
起止时间：
2018-05-01 至 2023-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9906938
关键词：
Adolescence Adult Affect Age Anatomy Anterior Bilateral Biometry Brain Brain region Caring Child Childhood Childhood Neurological Disorder Clinical Computer software Contralateral Data Development Diagnostic Disease Doctor of Medicine Doctor of Philosophy Epilepsy Evaluation Excision Functional Magnetic Resonance Imaging Goals Hippocampus (Brain)Hypoxia Image Impairment Ipsilateral Knowledge Language Lateral Learning Left Link Magnetic Resonance Imaging Measures Medial Memory Memory impairment Mentors Mentorship Methods Neuropsychology Operative Surgical Procedures Outcome Parietal Partial Epilepsies Patients Performance Play Postoperative Period Practice Guidelines Prefrontal Cortex Principal Investigator Process Protocols documentation Research Research Personnel Research Training Resistance Resolution Rest Retrieval Risk Role Seeds Seizures Specificity Structure System Technology Temporal Lobe Temporal Lobe Epilepsy Testing Training Training Programs United States Visual Work base childhood epilepsy dentate gyrus design hippocampal subregions imaging modality imaging study improved learning ability memory encoding memory process memory retrieval nervous system disorder neurodevelopment neuroimaging novel novel strategies relating to nervous system skills success theories tool visual memory

项目摘要

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.

项目概要摘要美国有 220 万成年人患有癫痫症，其中每 26 人中就有 1 人曾在某个时期患上癫痫症他们的生活。颞叶癫痫 (TLE) 是局灶性癫痫最常见的形式，为内侧结构，特别是海马体，很容易发生癫痫发作。选择性颞叶切除术有效 74-80% 的 TLE 患者得到治愈，但患者面临记忆功能受损的风险。为了尽量减少由于颞叶手术对记忆功能产生不利影响，因此需要可靠的术前指南。临床功能磁共振成像 (fMRI) 提供可靠、无创的语言指导在癫痫患者的术前评估中发挥作用。记忆功能磁共振成像也正在成为一种有用的方法预测成人结局的技术和新的 AAN 实践指南表明中等（B 级）证据基于成人研究的言语记忆功能磁共振成像可预测言语记忆结果。然而，没有记忆功能磁共振成像研究针对癫痫儿童。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，这些任务检查儿科 TLE 如何影响整个发育过程中记忆系统的功能解剖。我们的小说方法将神经心理学评估与标准和高分辨率的功能磁共振成像和磁共振成像联系起来，并且通过静息态连接来表征记忆的发育神经基础。该提案的目的是确定 TLE 儿童记忆功能的潜在重组：1) 在整个大脑层面，2）在海马体内，3）通过连接。该项目将建立功能磁共振成像 TLE 儿童术前记忆评估方案。该方案将改善手术根据重组的关键窗口确定最佳手术时机进行干预发生。首席研究员 Leigh Sepeta 博士是一位专门研究儿科和成人的神经心理学家癫痫，重点是癫痫语言和记忆映射的功能磁共振成像。她拥有深厚的背景神经发育、神经心理学和癫痫。拟议的培训计划将建立在她现有的基础上知识并促进三个目标：1）获得先进神经影像方法的专业知识，2）发展高分辨率神经影像、海马解剖学和海马分区分析的技能，以及 3) 提高生物统计分析技能。 Sepeta博士组建了强大的导师和顾问团队包括 William D. Gaillard（医学博士）、William H. Theodore（医学博士）、Chandan Y. Vaidya（博士）和 Susan Y. 布克海默博士（第二导师）。他们在儿科和成人癫痫、神经影像学、海马功能和神经心理学非常适合 Sepeta 博士提出的研究和培训计划。 Sepeta 博士为此 K23 提案设计的研究培训计划将进一步促进她的发展转变为专注于神经心理学和神经影像学的独立研究者的总体目标评估神经系统疾病（例如癫痫）的记忆力。