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

Publication ,  Journal Article
Kirov, II; Kuzniecky, R; Hetherington, HP; Soher, BJ; Davitz, MS; Babb, JS; Pardoe, HR; Pan, JW; Gonen, O
Published in: Epilepsy Res
January 2018

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.

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Published In

Epilepsy Res

DOI

EISSN

1872-6844

Publication Date

January 2018

Volume

139

Start / End Page

85 / 91

Location

Netherlands

Related Subject Headings

  • Young Adult
  • Proton Magnetic Resonance Spectroscopy
  • Organ Size
  • Neurology & Neurosurgery
  • Middle Aged
  • Male
  • Magnetic Resonance Imaging
  • Humans
  • Female
  • Epilepsies, Partial
 

Citation

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Kirov, I. I., Kuzniecky, R., Hetherington, H. P., Soher, B. J., Davitz, M. S., Babb, J. S., … Gonen, O. (2018). Whole brain neuronal abnormalities in focal epilepsy quantified with proton MR spectroscopy. Epilepsy Res, 139, 85–91. https://doi.org/10.1016/j.eplepsyres.2017.11.017
Kirov, Ivan I., Ruben Kuzniecky, Hoby P. Hetherington, Brian J. Soher, Matthew S. Davitz, James S. Babb, Heath R. Pardoe, Jullie W. Pan, and Oded Gonen. “Whole brain neuronal abnormalities in focal epilepsy quantified with proton MR spectroscopy.Epilepsy Res 139 (January 2018): 85–91. https://doi.org/10.1016/j.eplepsyres.2017.11.017.
Kirov II, Kuzniecky R, Hetherington HP, Soher BJ, Davitz MS, Babb JS, et al. Whole brain neuronal abnormalities in focal epilepsy quantified with proton MR spectroscopy. Epilepsy Res. 2018 Jan;139:85–91.
Kirov, Ivan I., et al. “Whole brain neuronal abnormalities in focal epilepsy quantified with proton MR spectroscopy.Epilepsy Res, vol. 139, Jan. 2018, pp. 85–91. Pubmed, doi:10.1016/j.eplepsyres.2017.11.017.
Kirov II, Kuzniecky R, Hetherington HP, Soher BJ, Davitz MS, Babb JS, Pardoe HR, Pan JW, Gonen O. Whole brain neuronal abnormalities in focal epilepsy quantified with proton MR spectroscopy. Epilepsy Res. 2018 Jan;139:85–91.
Journal cover image

Published In

Epilepsy Res

DOI

EISSN

1872-6844

Publication Date

January 2018

Volume

139

Start / End Page

85 / 91

Location

Netherlands

Related Subject Headings

  • Young Adult
  • Proton Magnetic Resonance Spectroscopy
  • Organ Size
  • Neurology & Neurosurgery
  • Middle Aged
  • Male
  • Magnetic Resonance Imaging
  • Humans
  • Female
  • Epilepsies, Partial