question regarding reported peripheral nerve stimulation - pediatric participants

[Suniyya A. Waraich]

Hello, 

Our team is running an fMRI study with children with congenital unilateral below-elbow deficiency (UCBED) to understand the neural basis of their control over their missing hand. 
As part of the study we are also collecting diffusion and resting state fMRI data from the participants in accordance with the HCP Lifespan (Development) protocols on a Siemens Prisma 3T scanner. 

I'm emailing because we ran our first participant who was a 12-year-old male with a congenital limb deficiency on his left side, i.e., left hand missing below the elbow. Before getting to the resting state scan, we ran a standard functional scan with a multiband factor of 4 (TR= 1.5s) and a 32-channel headcoil. The participant reported experiencing major discomfort with a pain rating of 6 out of 10, and a tingling sensation in his chest, which radiated to his left shoulder. We did not collect any more data. 

My question is: are there any research teams who have had a similar experience with pediatric participants reporting peripheral nerve stimulation? I would be especially interested in learning whether this has occurred when running any of the HCP-D scans, as we are trying to understand whether the multiband factor may have played a role (and the HCP rs-fMRI scan uses a higher multiband factor of 8). 

Relatedly, if anyone else has experienced this with pediatric participants (HCP-D or other), do you have any recommendations or guidelines that you could advise us —particularly with regard to safety, comfort, or protocol adjustments?

Best Regards,

Suniyya Waraich
Postdoctoral Researcher,
Laboratory of Dr. Jonathon Schofield
University of California, Davis

[Glasser, Matthew]

I don’t think the multi-band factor would interact with the likelihood of PNS.  Something like the echo spacing is more likely.  I get PNS pretty frequently in the scanner, but I am tall and broad shouldered.

 

In any case, we would recommend a somewhat different MRI protocol for the fMRI these days:

2.4mm isotropic

TR=1s, FA=60

60 slices

Optimized echo spacing (minimum or close to minimum)

This is all achievable with a MB=4 and the SNR is better than what we ran before without compromise for denoising or spatial localization.

 

Matt.

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[Suniyya A. Waraich]

Hi Dr. Glasser,

Thank you very much for your response. This helps to know. 

Best,

Suniyya 

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[Andreas Bartsch]

> I don’t think the multi-band factor would interact with the likelihood of PNS

 

Yes, because it is not the RF excitation pulse that causes PNS but primarily the rapidly alternating EPI read-out which does not differ between multiplexed and conventional EPI.

Thus, multiband EPI more easily runs into SAR but not PNS issues.

 

Cheers,

Andreas

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