Pediatric Language and Memory Mapping in Refractory Epilepsy Using Magnetoencephalography
Condition: Epilepsy
MeSH terms: Epilepsy; Drug Resistant Epilepsy
Study type: Observational

Summary: 
      This is a pilot research study where language and working memory tasks will be used to study
      brain activities from children with epilepsy. Specifically for language assessment, a
      well-known MEG language protocol will be used and novel signal processing techniques will be
      applied. A widely utilized paradigm will be used to study memory function and adapt
      signal-processing techniques from previous literature for the processing and analysis of MEG
      signals collected during memory task. No treatment/intervention will be performed or
      evaluated in this pilot research study.
    

Detailed description: 
      This is a pilot research study where language and working memory tasks will be used to study
      brain activities from children with epilepsy. Specifically for language assessment, a
      well-known MEG language protocol will be used and novel signal processing techniques will be
      applied. A widely utilized paradigm will be used to study memory function and adapt
      signal-processing techniques from previous literature for the processing and analysis of MEG
      signals collected during memory task. No treatment/intervention will be performed or
      evaluated in this pilot research study.

      A MEG scan will be performed and data will be collected from ten pediatric subjects with
      drug-resistant focal epilepsy under evaluation for resective surgery. If a MRI scan is
      available from medical records and images have the appropriate characteristics for MEG (see
      more specifications at MRI section) analysis, MRI will be used for MEG source reconstruction.
      If MRI is not available, one scan will be performed. MRI is necessary to obtain brain anatomy
      for high quality MEG source reconstruction.

      Quantitative parameters will be extracted from MEG data for evaluating language and memory
      functions. This is a pilot research study where we will test the feasibility of the recording
      of both standard language and well-known memory task in patients with epilepsy. This research
      is important to investigate, by a non-invasive means, possible patterns of language and
      memory organization that may in future guide surgery and limit potential loss of these
      functions.
    

Intervention name(s): Baseline MEG Test; Receptive Language Task; Memory Task
Intervention type(s): Diagnostic Test; Behavioral; Behavioral
Intervention description(s): Each subject will have one MEG session with the recordings of baseline resting state, language and memory protocols. Subjects will have a break period between the language and memory tasks. MEG recordings will be acquired for approximately 35 minutes. The subject will be allowed to practice the language and memory tasks before the MEG recording to feel familiar with them. This practice phase will be a short version of the task administered by a computer and will take approximately 6 minutes.; The subject will perform a practice session where they will be instructed to "try to remember" a set of ﬁve audibly spoken English words, deemed targets (jump, little, please, drink, and good). Depending on the subject's overall verbal memory capacity, the target words will be presented once or twice during the practice phase. Subsequently, during the MEG recording, the ﬁve target words will repeat in a different random order, mixed with a different set of 40 distractors (non-repeating words) in each of three blocks of stimuli. The subject's task will be to listen to the words and lift their index finger of the dominant hand whenever they hear a repeated target word (one of the five). After the language task, the subject will be given a break.; The subject will be tasked with indicating whether the encoding stimulus matched the retrieval stimulus using two buttons; one for "congruent" and the other for "incongruent" response. Button type will be counterbalanced among subjects. The task will take around 16 minutes. The visual stimuli will be projected through an LCD projector onto a white screen located about 0.5 m in front of the subject and subtending 1.0-4.0 and 0.5 degrees of horizontal and vertical visual angle, respectively. A MEG compatible keyboard will be used to measure the subject's responses for "congruent" and "incongruent". The subject will practice the memory task before going to the MEG system using a computer from MEG laboratory. This practice phase will consist of a short version of the memory task with duration of approximately 4 minutes.
Other intervention name(s): MEG Acquisition
Observational model: Other
Time perspective: Other
Sampling method: Probability Sample
Study population: 
        A total of fifteen (15) pediatric patients with drug-resistant focal epilepsy under
        evaluation for resective surgery will be recruited from the comprehensive epilepsy program
        of the Arkansas Children's Neuroscience Center. If the patient is eligible, they will be
        informed about this study during their routine clinic visits by their clinician, and asked
        if they are interested in participating. Those who express an interest will be provided
        with the informed consent form (ICF) approved by the UAMS Institutional Review Board (IRB).