Functional Magnetic Resonance Imaging (fMRI) for paediatric language mapping in epilepsy: a methodological review and empirical evaluation of approaches

Cattani, Megan 2026. Functional Magnetic Resonance Imaging (fMRI) for paediatric language mapping in epilepsy: a methodological review and empirical evaluation of approaches. ClinPsy Thesis, Cardiff University. Item availability restricted.

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Abstract

Abstract Objectives: Functional Magnetic Resonance Imaging (fMRI) is emerging as a widely used, non-invasive tool for language mapping in paediatric epilepsy populations. However, to date no known reviews have focused on methodological diversity in fMRI analysis methods. The aims of this review were to 1) identify the different fMRI analysis methods used in language mapping in the existing literature 2) provide a synthesis of available evidence in terms of accuracy, reliability and sensitivity to inform future research and practice. Methods: A systematic search of PubMed, Scopus, Embase.com, MEDLINE, and PsycINFO (up to November 2025) was conducted. Records of cohort studies that reported mapping techniques using fMRI in paediatric epilepsy were identified. Quality appraisal was undertaken with QUADAS-2 informed by COBIDAS guidelines. Analysis methods, findings, reference standards and post-operative comparisons were synthesised across studies. Results: Nineteen studies met criteria for inclusion. The review found Region of Interest (84%), Task-based fMRI Laterality Index methods (42%) and Resting State Independent Component Analysis methods (21%) were most commonly used, along with single fixed thresholds (42%) and dominance classifications using a ±0.2 threshold method (58%). Both methods demonstrated moderate to high concordance with clinically validated measures of language lateralisation. However, performance was reduced for cases of atypical lateralisation, an important implication in the context of routine application in surgical consideration. Conclusions: High heterogeneity across language lateralisation methods was found, demonstrating the need for standardised protocols. Exploration of threshold independent methods and strength based dominance classifications is needed to encapsulate the variability of language lateralisation in this population.

Item Type:	Thesis (DClinPsy)
Date Type:	Completion
Status:	Unpublished
Schools:	Schools > Psychology
Subjects:	B Philosophy. Psychology. Religion > BF Psychology
Uncontrolled Keywords:	fMRI, Systematic Review, Paediatric Epilepsy, Language Lateralisation, Surgical Planning
Funders:	N/A
Date of First Compliant Deposit:	28 July 2026
Last Modified:	30 Jul 2026 14:48
URI:	https://orca.cardiff.ac.uk/id/eprint/188508

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