Whole brain neuronal abnormalities in focal epilepsy quantified with proton MR spectroscopy.

Journal Article (Journal Article)

OBJECTIVE: To test the hypothesis that localization-related epilepsy is associated with widespread neuronal dysfunction beyond the ictal focus, reflected by a decrease in patients' global concentration of their proton MR spectroscopy (1H-MRS) observed marker, N-acetyl-aspartate (NAA). METHODS: Thirteen patients with localization-related epilepsy (7 men, 6 women) 40±13 (mean±standard-deviation)years old, 8.3±13.4years of disease duration; and 14 matched controls, were scanned at 3 T with MRI and whole-brain (WB) 1H MRS. Intracranial fractions of brain volume, gray and white matter (fBV, fGM, fWM) were segmented from the MRI, and global absolute NAA creatine (Cr) and choline (Cho) concentrations were estimated from their WB 1H MRS. These metrics were compared between patients and controls using an unequal variance t test. RESULTS: Patients' fBV, fGM and fWM: 0.81±0.07, 0.47±0.04, 0.31±0.04 were not different from controls' 0.79±0.05, 0.48±0.04, 0.32±0.02; nor were their Cr and Cho concentrations: 7.1±1.1 and 1.3±0.2 millimolar (mM) versus 7.7±0.7 and 1.4±0.1mM (p>0.05 all). Patients' global NAA concentration: 11.5±1.5 mM, however, was 12% lower than controls' 13.0±0.8mM (p=0.004). CONCLUSIONS: These findings indicate that neuronal dysfunction in localization-related epilepsy extends globally, beyond the ictal zone, but without atrophy or spectroscopic evidence of other pathology. This suggests a diffuse decline in the neurons' health, rather than their number, early in the disease course. WB 1H-MRS assessment, therefore, may be a useful tool for quantification of global neuronal dysfunction load in epilepsy.

Full Text

Duke Authors

Cited Authors

  • Kirov, II; Kuzniecky, R; Hetherington, HP; Soher, BJ; Davitz, MS; Babb, JS; Pardoe, HR; Pan, JW; Gonen, O

Published Date

  • January 2018

Published In

Volume / Issue

  • 139 /

Start / End Page

  • 85 - 91

PubMed ID

  • 29212047

Pubmed Central ID

  • PMC6411059

Electronic International Standard Serial Number (EISSN)

  • 1872-6844

Digital Object Identifier (DOI)

  • 10.1016/j.eplepsyres.2017.11.017


  • eng

Conference Location

  • Netherlands