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Related Experiment Videos

Multisection proton MR spectroscopy for mesial temporal lobe epilepsy.

Arístides A Capizzano1, Peter Vermathen, Kenneth D Laxer

  • 1Department of Veterans Affairs Medical Center, Magnetic Resonance Spectroscopy Unit, University of California, San Francisco, USA.

AJNR. American Journal of Neuroradiology
|September 12, 2002
PubMed
Summary

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Proton MR spectroscopy ((1)H-MRS) reveals reduced N-acetylaspartate (NAA) in mesial temporal lobe epilepsy (mTLE) beyond the hippocampus. This technique accurately lateralizes seizure foci, aiding diagnosis and treatment planning.

Area of Science:

  • Neuroimaging
  • Metabolic Neuroscience
  • Epilepsy Research

Background:

  • Mesial temporal lobe epilepsy (mTLE) is associated with significant metabolic impairments.
  • Previous studies indicate metabolic changes within the hippocampus in mTLE.
  • The extent of metabolic alterations beyond the hippocampus in mTLE remains to be fully elucidated.

Purpose of the Study:

  • To investigate metabolic changes in mesial temporal lobe epilepsy (mTLE) using proton MR spectroscopy ((1)H-MRS) in regions beyond the hippocampus.
  • To determine if these metabolic changes can aid in lateralizing the seizure focus in mTLE patients.

Main Methods:

  • MR imaging and (1)H-MRS were performed on 15 mTLE patients and 12 controls.
  • N-acetylaspartate (NAA), creatine (Cr), and choline (Cho) were measured in various brain regions, including the hippocampus, temporal cortex, insula, cerebellum, and frontal, parietal, and occipital lobes.

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  • Metabolites were quantified as ratios to Cr and in absolute units.

    • Main Results:

    • Patients with mTLE showed significantly lower absolute NAA in the ipsilateral hippocampus compared to controls and the contralateral side.
    • Metabolic reductions (NAA) extended beyond the hippocampus to the ipsilateral temporal lobes, with significant differences observed compared to controls and contralateral values.
    • While hippocampal data alone lateralized 60% of cases, whole temporal lobe data achieved 87% sensitivity and 92% specificity for seizure focus lateralization.
    • Bilaterally reduced NAA was observed in the frontal, parietal, and occipital lobes of mTLE patients.

    Conclusions:

    • Multisection (1)H-MRS effectively detects interictal reductions of NAA in the temporal lobe, extending beyond the hippocampus in mTLE.
    • This advanced MR spectroscopy technique provides accurate lateralization of seizure foci in mTLE patients.
    • Findings suggest (1)H-MRS can offer valuable insights into the broader metabolic consequences of mTLE and assist in clinical localization.