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Updated: Jul 31, 2026
Network Analysis of the Default Mode Network Using Functional Connectivity MRI in Temporal Lobe Epilepsy
Published on: August 5, 2014
Spectroscopic metabolic abnormalities in mTLE with and without MRI evidence for mesial temporal sclerosis using
Susanne G Mueller1, Kenneth D Laxer, Joyce Suhy
1Department of Veterans Affairs (DVA) Medical Center, Magnetic Resonance Spectroscopy Unit Pacific Epilepsy Program, California Pacific Medical Center, San Francisco, California 94115, U.S.A.
Purpose:
Long echo time (TE) spectroscopy reliably identifies the epileptogenic hippocampus in mesial temporal lobe epilepsy. Short-TE spectroscopy gives additional metabolic information but may have more artifacts. The aim of this study was to test (a) lateralization of the seizure focus by short-TE spectroscopy, and (b) value of myoinositol (MI) in the identification of the epileptogenic hippocampus.
Methods:
Twenty-four patients with temporal lobe epilepsy: 16 with mesial temporal sclerosis (TLE-MTS), eight patients with normal magnetic resonance imaging (MRI; TLE-No), and 16 controls were studied with hippocampal 2D short-TE magnetic resonance spectroscopic imaging (MRSI).
Results:
In TLE-MTS, the ipsilateral N-acetylaspartate (NAA) was decreased compared with contralateral (p = 0.03) or controls (p = 0.007). Additionally, the ipsilateral MI was decreased compared with controls (p = 0.012). TLE-No values showed no side differences and were not different from controls. Abnormalities in the anterior hippocampus correctly lateralized the epileptogenic hippocampus in
Conclusions:
The accuracy of short-TE MRSI at 1.5 T for focus lateralization in mTLE is comparable to that of long-TE MRSI. MI might be helpful for focus lateralization, but more information about the factors influencing the MI concentration is needed.
Insights
Short echo time magnetic resonance spectroscopic imaging (MRSI) accurately lateralizes the seizure focus in mesial temporal lobe epilepsy (mTLE). Myoinositol (MI) may aid focus identification, though further research is needed.
Area of Science:
- Neuroimaging
- Epilepsy Research
- Metabolic Spectroscopy
Background:
- Mesial temporal lobe epilepsy (mTLE) diagnosis often relies on identifying the epileptogenic hippocampus.
- Long echo time (TE) magnetic resonance spectroscopic imaging (MRSI) is established for this, but short-TE MRSI offers additional metabolic insights.
- Short-TE MRSI may be susceptible to artifacts, necessitating careful evaluation.
Purpose of the Study:
- To assess the capability of short-TE MRSI for lateralizing the seizure focus in mTLE.
- To determine the utility of myoinositol (MI) levels in identifying the epileptogenic hippocampus.
Main Methods:
- Hippocampal 2D short-TE MRSI was performed on 24 patients with temporal lobe epilepsy (TLE) and 16 controls.
- Patient groups included 16 with TLE and mesial temporal sclerosis (TLE-MTS) and 8 with normal MRI (TLE-No).
Main Results:
- In TLE-MTS, ipsilateral N-acetylaspartate (NAA) was significantly decreased compared to controls or the contralateral side (p ≤ 0.03).
- Ipsilateral myoinositol (MI) was also decreased in TLE-MTS patients compared to controls (p = 0.012).
- Short-TE MRSI accurately lateralized the epileptogenic hippocampus in up to 82% of TLE-MTS and 80% of TLE-No patients.
Conclusions:
- Short-TE MRSI at 1.5 T demonstrates comparable accuracy to long-TE MRSI for seizure focus lateralization in mTLE.
- Myoinositol (MI) shows potential as a biomarker for focus lateralization, but influencing factors require further investigation.
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