Abstracts

Rationale: Neurosurgery is widely accepted as one of the most effective treatment options to cure childhood diseases such as drug-resistant epilepsy. Despite the developing brain’s striking capacity for plasticity and reorganization, surgical resection of tissue harboring the lesion may have detrimental effects on socio-cognitive functioning. While neuroimaging studies have shown high sensitivity in identifying the pre-operative surgical target, an umbrella framework consolidating brain structure and function able to predict post-operative cognitive status is still lacking. Our goal is to acquire high-resolution longitudinal imaging data to assess pre- to post-operative brain reorganization in children undergoing resective surgery, which will be made freely available to the scientific community. Methods: When complete, our open-access multimodal imaging and out-of-scanner behavioral datasets will comprise approximately 40 children suffering from drug-resistant focal epilepsy, measured shortly before and one year after surgery. Using equivalent measures and time intervals, we will also release data from 20 age- and sex-matched healthy children. Brain imaging sessions include: (i) 3D T1w MRI with prospective motion correction (PROMO), (ii) 3D T2- FLAIR PROMO, (iii) 3D qT1 PROMO, (iv) 3D ASL, (v) rs-fMRI (inscapes, movie “The Present”), (vi) task-based fMRI (semantic decision, finger tapping, n-back), and (vii) multi-shell diffusion MRI (FIGURE 1), as well as (viii) a battery of behavioral and clinical neuropsychological tasks. Results: As a proof-of-concept, we demonstrated the utility of integrating different scan modalities to accurately lateralize the seizure focus in a child with a right parahippocampal lesion. A seed-based functional connectivity analysis centered on the hypothesized epileptogenic lesion further revealed perturbed connectivity to higher-order cognitive networks and temporo-limbic circuits (FIGURE 2). Conclusions: Our platform will push the boundaries of personalized connectome models of pediatric focal epilepsy at unprecedented spatial and temporal resolution. We are eager for a range of scientists and clinicians to leverage these data to test their own hypotheses about pediatric childhood epilepsy and ultimately optimize pre-surgical planning and cognitive prognosis for children undergoing brain surgery. Funding: CIHR, SickKids Foundation, FRQS, NSERC, Azrieli Foundation