Fmri for Bilingual Epilepsy Surgery Patients: Serving a Diverse Pediatric Cohort
Abstract number :
3.266
Submission category :
5. Neuro Imaging / 5B. Functional Imaging
Year :
2022
Submission ID :
2205093
Source :
www.aesnet.org
Presentation date :
12/5/2022 12:00:00 PM
Published date :
Nov 22, 2022, 05:28 AM
Authors :
Hillary Shurtleff, PhD, ABPP – Seattle Children's Hospital; Hannah Goldstein, MD – Seattle Children's Hospital; Andrew Poliakov, PhD – Seattle Children's Hospital; Molly Warner, PhD, ABPP – Seattle Children's Hospital; Dennis Shaw, MD – Seattle Children's Hospital; Edward Novotny, MD – Seattle Children's Hospital; Russell Saneto, DO, PhD – Seattle Children's Hospital; Kristina Patrick, PhD, ABPP – Seattle Children's Hospital; Jason Hauptman, MD, PhD – Seattle Children's Hospital; Jeffrey Ojemann, MD – Seattle Children's Hospital
Rationale: Functional MRI (fMRI) helps with the identification of eloquent cortex to assist with preservation of function for patients who undergo epilepsy surgery. Language and memory tasks can even be used effectively in pediatric patients. Though there is a need to serve a diversity of patients, most adult and pediatric studies report on English speaking only cohorts. Our study evaluated the efficacy of pediatric fMRI for Language Other than English (LOE), including primarily bilingual patients, undergoing epilepsy surgery workups.
Methods: We reviewed epilepsy surgery workup patients at Seattle Children’s Hospital and identified all patients who had valid verbal fluency fMRI tasks between 2007 and 2019 and specifically the LOE and bilingual patients within this cohort. We identified the percentage of LOE-bilingual patients and the range of LOEs, compared the LOE vs. English activation in bilingual patients, and compared individual case fMRI verbal task findings with available grid and awake OR mapping findings.
Results::Of the 306 epilepsy surgery workup patients who had successful verbal fluency fMRI tasks during 2007-2019, 39 (13%) were LOE or bilingual patients. Two patients were fluent only in one non-English language and thus had LOE scans only; 14 were bilingual and had LOE plus English scans; 20 were bilingual though chose to have only English language scans; 3 were from bilingual families who heard and understood LOEs every day though chose to not speak their family LOE and chose English language scans. LOEs scanned included primarily Spanish, but also the following: Kirundi, German, Punjabi, Italian, Cantonese, Ilokano, Arabic, and Vietnamese. Additional bilingual LOEs not scanned included: KiSwahili, Tagalog, Hmong, Bosnian, Farsi, Chinese, Telugu, and Korean. Consistent with adult data on 16 patients (Centeno et al, Epilepsia, 2014), individual bilingual scans showed similarity between the LOE and English though the adult study had one discrepant case. We also found fMRI findings were concordant with the few Wada Test and grid and awake OR mapping tests available.
Conclusions: Language fMRI tasks can be completed effectively with LOE and bilingual pediatric patients as part of epilepsy surgery workups, regardless of language spoken by the patient. Results between LOEs and English were generally consistent, as were results between fMRIs and the few other tests available, including Wada and grid and awake OR mapping. Important future steps need to include larger samples as well as standards for fMRI assessments with a diversity of patients, including bilingual pediatric patients, particularly those who may or may not want to acknowledge their LOE as these children and adolescents assimilate into a new culture.
Funding: Richard G. Ellenbogen Endowed Chair in Pediatric Neurological Surgery supported this work.
Neuro Imaging