Abstract
There has been increasing interest in the clinical and experimental use of memory functional Magnetic Resonance Imaging (fMRI). The 2017 American Academy of Neurology practice guidelines on the use of pre-surgical cognitive fMRI suggests that verbal memory fMRI could be used to lateralize memory functions in people with Temporal Lobe Epilepsy (TLE) and should be used to predict post-operative verbal memory outcome. There are however technical and methodological considerations, to optimize both the sensitivity and specificity of this imaging modality. Below we discuss these constraints and suggest recommendations to consider when designing a memory fMRI paradigm.
Highlights
The most important cognitive comorbidity of Temporal Lobe Epilepsy (TLE) is impairment in episodic memory
We aim to provide a guide for clinicians and researchers to design a memory functional Magnetic Resonance Imaging (fMRI) protocol for pre-surgical evaluation of memory in TLE
Sidhu et al later included a third response option (“Familiar”) to distinguish between the processes of recollection (“Remember” response) and familiarity (“Familiar” response). This type of paradigm provides information about the neural network associated with the encoding phase of memory, but not the network that is involved in the retrieval of mnemonic information
Summary
The most important cognitive comorbidity of TLE is impairment in episodic memory. The hippocampus plays a major role in the generation and spread of temporal lobe seizures [1], and it is a critical structure serving long-term memory, including episodic memory [2]. A potential drawback with these paradigms relates to the fact that brain activation associated with the retrieval of studied items could reflect either familiarity or recollection processes This could lead to inaccurate conclusions regarding the differential role of sub-regions engaged within the MTL. Paradigms like the “Old/New” or “Remember/Know” can be adapted to either measure brain activity during the encoding phase or the retrieval phase of the memory process Sidhu et al later included a third response option (“Familiar”) to distinguish between the processes of recollection (“Remember” response) and familiarity (“Familiar” response) This type of paradigm provides information about the neural network associated with the encoding phase of memory, but not the network that is involved in the retrieval of mnemonic information. Obtaining robust hippocampal activation at the individual level has proven challenging across fMRI studies [63, 64], but a wider approach to memory mapping involving two memory phases (encoding and retrieval) may increase the sensitivity of this
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