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Multisection proton MR spectroscopy for mesial temporal lobe epilepsy.

Publication ,  Journal Article
Capizzano, AA; Vermathen, P; Laxer, KD; Matson, GB; Maudsley, AA; Soher, BJ; Schuff, NW; Weiner, MW
Published in: AJNR Am J Neuroradiol
September 2002

BACKGROUND AND PURPOSE: Extensive metabolic impairments have been reported in association with mesial temporal lobe epilepsy (mTLE). We investigated whether proton MR spectroscopy ((1)H-MRS) depicts metabolic changes beyond the hippocampus in cases of mTLE and whether these changes help lateralize the seizure focus. METHODS: MR imaging and (1)H-MRS were performed in 15 patients with mTLE with a postoperative diagnosis of mesial temporal sclerosis and in 12 control volunteers. Point-resolved spectroscopy and multisection (1)H-MRS measured N-acetylaspartate (NAA), creatine (Cr), and choline (Cho) in the hippocampus, temporal opercular and lateral cortices, insula and cerebellum, and frontal, parietal, and occipital lobes. Metabolites were assessed as ratios to Cr and in absolute units. RESULTS: Twelve patients had ipsilateral hippocampal atrophy; three had negative imaging results. In the ipsilateral hippocampus, absolute NAA (/NAA/) was 27.3% lower in patients compared with that in control volunteers (P <.001) and 18.5% lower compared with that in the contralateral side (P <.01). /NAA/ averaged over selected regions in the ipsilateral temporal lobes of patients with mTLE was 19.3% lower compared with the mean in the control group (P <.0001) and by 17.7% lower compared with the contralateral values (P <.00001). Using only hippocampal data, 60% of the cases of mTLE were correctly lateralized. Lateralization, determined using whole temporal lobe data, had 87% sensitivity and 92% specificity. /NAA/ was bilaterally reduced in the frontal, parietal, and occipital lobes of patients with mTLE compared with that in control volunteers (P <.01). CONCLUSION: Multisection (1)H-MRS depicts interictal reductions of NAA in the ipsilateral temporal lobe beyond the hippocampus and accurately lateralizes seizure foci.

Duke Scholars

Published In

AJNR Am J Neuroradiol

ISSN

0195-6108

Publication Date

September 2002

Volume

23

Issue

8

Start / End Page

1359 / 1368

Location

United States

Related Subject Headings

  • Nuclear Medicine & Medical Imaging
  • Middle Aged
  • Male
  • Magnetic Resonance Spectroscopy
  • Humans
  • Hippocampus
  • Female
  • Epilepsy, Temporal Lobe
  • Creatine
  • Choline
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Capizzano, A. A., Vermathen, P., Laxer, K. D., Matson, G. B., Maudsley, A. A., Soher, B. J., … Weiner, M. W. (2002). Multisection proton MR spectroscopy for mesial temporal lobe epilepsy. AJNR Am J Neuroradiol, 23(8), 1359–1368.
Capizzano, Arístides A., Peter Vermathen, Kenneth D. Laxer, Gerald B. Matson, Andrew A. Maudsley, Brian J. Soher, Norbert W. Schuff, and Michael W. Weiner. “Multisection proton MR spectroscopy for mesial temporal lobe epilepsy.AJNR Am J Neuroradiol 23, no. 8 (September 2002): 1359–68.
Capizzano AA, Vermathen P, Laxer KD, Matson GB, Maudsley AA, Soher BJ, et al. Multisection proton MR spectroscopy for mesial temporal lobe epilepsy. AJNR Am J Neuroradiol. 2002 Sep;23(8):1359–68.
Capizzano, Arístides A., et al. “Multisection proton MR spectroscopy for mesial temporal lobe epilepsy.AJNR Am J Neuroradiol, vol. 23, no. 8, Sept. 2002, pp. 1359–68.
Capizzano AA, Vermathen P, Laxer KD, Matson GB, Maudsley AA, Soher BJ, Schuff NW, Weiner MW. Multisection proton MR spectroscopy for mesial temporal lobe epilepsy. AJNR Am J Neuroradiol. 2002 Sep;23(8):1359–1368.

Published In

AJNR Am J Neuroradiol

ISSN

0195-6108

Publication Date

September 2002

Volume

23

Issue

8

Start / End Page

1359 / 1368

Location

United States

Related Subject Headings

  • Nuclear Medicine & Medical Imaging
  • Middle Aged
  • Male
  • Magnetic Resonance Spectroscopy
  • Humans
  • Hippocampus
  • Female
  • Epilepsy, Temporal Lobe
  • Creatine
  • Choline