The advent of magnetic resonance imaging (MRI) has opened up new possibilities for studying human brain structure and function across the lifespan. An increase in the use of structural and functional MRI (fMRI) in infants and young children can further add to our understanding of brain development. For example, MRI research has revealed differences in brain structure and function in individuals with disabilities (e.g., dyslexia1–3
) compared with typical controls, and working with infants and young children may unveil the developmental trajectory of such disabilities. Neuroimaging young children additionally allows for the investigation of brain plasticity during this rapid developmental period and can potentially reveal how certain perceptual, procedural, and cognitive skills, such as music perception and musical skills, develop.4
However, in contrast to studies in school-aged children and adults, MRI research in young pediatric age groups is less common.5
Studies involving children under the age of 6 are particularly rare, given the practical and technical challenges involved (e.g., Refs. 5, 6
). Practical challenges of pediatric neuroimaging sessions include procedural difficulties (e.g., participants’, anxiety or motivation, movement restriction, putting an infant to sleep in an unfamiliar environment, and parent’s anxiety), technical obstacles (e.g., availability of child-appropriate equipment, masking and attenuation of scanner background noise [SBN]), as well as the challenge of choosing the most appropriate analysis methods (e.g., pediatric brain templates and adequate movement detection tools). In clinical populations, MRIs of infants and children are routinely obtained under sedation,7–9
which eliminates a subset of these challenges. However, for ethical reasons, sedation is not an option for most developmental neuroimaging research. Furthermore, there is a strong push from clinicians and hospital administrators to reduce the overall need for sedation and anesthesia for cost containment and more importantly to prevent any potential negative sequelae, particularly in those receiving multiple MRI studies.
Several methods have been developed to improve an infant or child’s compliance during neuroimaging sessions within the clinical (e.g., Refs. 10–12
) or research setting (e.g., Refs. 13, 14
). General approaches for imaging young children include play therapy,14
the use of mock scanner areas,13–19
and a combination of these techniques.21
The most common practices for nonse-dated newborns and infants are the natural sleep technique22–25
and the feed and wrap procedure.26,27
Figures S1 and S2
provide a literature overview of published protocols, guidelines, and empirical research studies using pediatric neuroimaging protocols and their sample size and success rate.
This paper summarizes successful methods for applying guidelines and recommendations on how to successfully perform neuroimaging studies in nonsedated infants and young children. Furthermore, strategies for overcoming experimental and analysis limitations and ethical implications of neuroimaging in pediatric populations are discussed.