Neuropediatrics 2010; 41 - P1341
DOI: 10.1055/s-0030-1265587

Feasibility of functional MRI in children and adolescents with neurological disorders – the Vogtareuth experience

A Zsoter 1, M Wilke 2, H Eitel 3, S Kessler 3, A Karlmeier 3, M Staudt 1
  • 1Klinik für Neuropädiatrie und Neurologische Rehabilitation, Epilepsiezentrum für Kinder und Jugendliche, BHZ Vogtareuth, Experimentelle Pädiatrische Neurobildgebung, Kinderklinik und Klinik für Neuroradiologie, Eberhard Karls Universität Tübingen
  • 2Abteilung Neuropädiatrie und Entwicklungsneurologie, Kinderklinik, und Experimentelle Pädiatrische Neurobildgebung, Kinderklinik und Klinik für Neuroradiologie, Eberhard Karls Universität Tübingen
  • 3Klinik für Neuropädiatrie und Neurologische Rehabilitation, Epilepsiezentrum für Kinder und Jugendliche, Behandlungszentrum Vogtareuth

Introduction: Functional MRI in children and adolescents with cognitive or behavioral impairments still is challenging, mostly due to increased motion and reduced compliance.

We report our experience in these patients who performed an fMRI mainly as part of the presurgical evaluation for pharmaco-refractory epilepsies.

Patients and methods: Between 03/2009 and 03/2010 36 patients underwent fMRI, analyzable data were obtained in 34 (20 girls; mean age 11.8 years, range 6.4–19.6 years). Altogether 177 sessions were measured (56 sensorimotor, 121 language). Patients performed between 2 and 10 sessions each. fMRI was performed on a 1.5 T Siemens Symphony, all paradigm in a block-design with alternating active and rest/control blocks (length 30s).

Data analysis in the clinical setting was done with company-provided fMRI software and in some cases for export into intraoperative neuronavigation with BRAINLAB iPlan 2.6. For scientific purposes, preprocessing and statistic analysis was performed based on the general linear model with the SPM8-Software (Welcome Trust Centre for NeuroImaging, UC London).

Results: 17 functional sessions (4 sensorimotor, 13 language) were rejected because of excessive motion (>3mm residual translation after online-motion-correction at any time of the functional session).

More detailed analyses of motion parameters showed:

  • a significant negative correlation with age (r=–0.35 [translation], r=–0.37 [rotation]; p<0.001)

  • no significant effect of the number of previously performed sessions on motion parameters

  • no significant difference between boys and girls

  • no significant difference in the amount of motion between sensorimotor and language paradigms

  • a significantly stronger motion during the active versus rest periods in motor paradigms (r=0.34 [translation] und r=0.28 [rotation], p<0.01).

Conclusion: This analysis confirms previous observations of a correlation of motion with age and fMRI task. In addition, we could show that the number of sessions already performed (ie, time in the scanner) does not increase motion. We conclude that, in the appropriate setting, it is well possible to perform clinical functional MRI even in mentally retarded children and adolescents.