Time course of postoperative recovery of N-acetyl-aspartate in temporal lobe epilepsy
Time course of postoperative recovery of N-acetyl-aspartate in temporal lobe epilepsy
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DOI：
10.1046/j.1528-1157.2001.01300.x
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发表时间：
2001-02-01
期刊：
影响因子：
5.6
通讯作者：
Arnold, DL
中科院分区：
文献类型：
--
作者：
Serles, W;Li, LM;Arnold, DL
目的：评估N-乙酰天冬氨酸/肌酸（NAA/Cr）升高的时间过程，可使用质子MR光谱成像（H-1-MRSI）进行测量。方法：对16例无瘤（SF）和16例非无瘤（NSF）的难治性非病灶性颞叶长袍癫痫（TLE）患者进行术前和术后H-1-MRSI检查。我们计算了SF和NSF组之间的混合设计方差分析（ANOVA），同侧和对侧的操作，以及术前和术后NAA/Cr测量。结果：混合设计方差分析显示：（a）SF组术后NAA/Cr显著高于NSF组（p = 0.02），（B）SF组术后NAA/Cr显著高于NSF组（p = 0.02）。术后NAA/Cr值明显高于术前（p < 0.05），大部分患者恢复正常。根据我们的非线性回归模型，在SF患者，有50%的增加相对于术前NAA/Cr值后5.8个月，而95%的改善后达到25 months.Conclusions：我们的结果扩展初步观察SF患者术后NAA恢复的特征恢复的时间过程为一个指数函数，半个月的时间。远离癫痫灶的神经元代谢功能障碍的逆转可能是癫痫手术成功后认知功能障碍改善的临床观察的基础。
Purpose: To assess the time course of increases in N-acetyl-aspartate/creatine (NAA/Cr), which can be measured using proton MR spectroscopic imaging (H-1-MRSI). in patients with intractable nonlesional temporal robe epilepsy (TLE) after successful epilepsy surgery.Methods: We performed pre- and postoperative H-1-MRSI in 16 seizure-free (SF) patients and 16 not seizure-free (NSF) TLE patients. We calculated a mixed-design analysis of variance (ANOVA) between SF and NSF groups, ipsi- and contralateral to the side of operation, and pre- and postoperative NAA/Cr measurements. We applied nonlinear regression be tween pre- and postoperative NAA/Cr differences and the time interval between H-1-MRSI scans to fit a negative exponential model to NAA recovery.Results: Mixed-design ANOVA revealed that (a) postoperative NAA/Cr was significantly higher in SF than in NSF patients (p = 0.02) and that (b) in the SF group. postoperative NAA/Cr values were significantly higher than preoperative values (p < 0.05) and returned to the normal range in most patients. According to our nonlinear regression model, in SF patients, there was a 50% increase relative to preoperative NAA/Cr values after 5.8 months, whereas an improvement of 95% was reached after 25 months.Conclusions: Our results extend preliminary observations of postoperative NAA recovery of SF patients by characterizing the time course of recovery as an exponential function with a half-time of 6 months. The reversal of neuronal metabolic dysfunction remote from the epileptic focus may underlie the clinical observation of improvement of cognitive dysfunction after successful epilepsy surgery.