Is the intracellular pH different from normal in the epileptic focus of patients with temporal lobe epilepsy? A P-31 NMR study
Is the intracellular pH different from normal in the epileptic focus of patients with temporal lobe epilepsy? A P-31 NMR study
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DOI：
10.1212/wnl.47.3.756
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发表时间：
1996-09-01
期刊：
影响因子：
9.9
通讯作者：
Elgavish, GA
中科院分区：
文献类型：
--
作者：
Chu, WJ;Hetherington, HP;Elgavish, GA
我们在4.1T全身NMR系统上进行了人脑的活体P-31 NMR光谱研究。基于20名健康志愿者的对照组，左颞叶的正常pH（i）为7.05（SD，0.06; SEM，0.01），右颞叶为7.04（SD，0.04; SEM，0.01）。我们还研究了由13名单侧颞叶癫痫患者组成的患者组。同侧肺叶的平均pH（i）为7.02（SD，0.04; SEM，0.01），对侧肺叶为7.02（SD，0.05; SEM，0.01）。这些结果清楚地表明，无论是在正常对照还是在患者中，在两个肺叶之间均未观察到pH（i）的统计学显著差异。此外，对照组和患者组之间不存在显著的pH（i）差异。根据同侧叶和对侧叶之间的个体pH（i）差异，对13例单侧癫痫患者进行偏侧化（Δ pH（i）），显示三名患者为非诊断病例，因为他们的Δ pH（i）与零无显著差异（小于或等于0.02），5名患者显示与其临床偏侧一致的小Δ pH（i），而其余5名患者显示与临床结果相反的基于Δ pH（i）的偏侧化。这些结果似乎表明在+/-0.02 pH单位的非常小的实验误差内，Δ pH（i）= 0附近基本上是随机分布的。从13名单侧患者的8个不同区域获得的pH（i）也没有显示任何显著的非零Δ pH（i）值。这些结果得出的结论是，即使在4.1 T机器的出色光谱分辨率和再现性（典型SD为0.05 pH单位）下，也未检测到颞叶癫痫诱导的显著pH（i）效应。因此，在本研究中，Delta pH（i）似乎不是颞叶癫痫患者癫痫灶定侧的临床有用工具。
We performed in vivo P-31 NMR spectroscopic studies of human brain on a 4.1 T whole-body NMR system. Based on a control group of 20 healthy volunteers, the normal pH(i) was 7.05 (SD, 0.06; SEM, 0.01) in the left temporal lobe and 7.04 (SD, 0.04; SEM, 0.01) in the right temporal lobe. We also studied a patient group consisting of 13 individuals with unilateral temporal lobe epilepsy. The mean pH(i) was 7.02 (SD, 0.04; SEM, 0.01) in the ipsilateral lobe and 7.02 (SD, 0.05; SEM, 0.01) in the contralateral lobe. These results clearly show that no statistically significant difference in pH(i) is observed between the two lobes, either in normal controls or in patients. Also, no significant pH(i) difference exists between the control group and the patient group. Lateralization in each of the 13 patients with unilateral epilepsy, based on their individual pH(i) difference between the ipsilateral lobe and contralateral lobe (Delta pH(i)), showed that three patients were nondiagnostic cases because their Delta pH(i)s were not significantly different from zero (less than or equal to 0.02), five patients showed small Delta pH(i)s consistent with their clinical lateralization, whereas the remaining five patients showed Delta pH(i)-based lateralization opposite to the clinical findings. These results seem to indicate an essentially random distribution around Delta pH(i) = 0 within a very small experimental error of +/- 0.02 pH units. pH(i) obtained from eight different areas in each of the 13 unilateral patients also did not show any significantly nonzero Delta pH(i) values. These results led to the conclusion that even at the excellent spectral resolution and reproducibility of the 4.1 T machine (typical SD of 0.05 pH units), no significant pH(i) effect, induced by temporal lobe epilepsy, could be detected. Therefore, in this study, Delta pH(i) does not appear to be a clinically useful tool for the lateralization of epileptic foci in patients with temporal lobe epilepsy.