1H-MRS profile in MRI positive- versus MRI negative patients with temporal lobe epilepsy
1H-MRS profile in MRI positive- versus MRI negative patients with temporal lobe epilepsy
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DOI：
10.1016/j.seizure.2008.01.008
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发表时间：
2008-09-01
影响因子：
3
通讯作者：
Hammen, T.
中科院分区：
文献类型：
--
作者：
Doelken, M. T.;Stefan, H.;Hammen, T.
简介：本研究的目的是定量和比较颞叶癫痫 (TLE) 患者海马同侧总 N-乙酰天冬氨酸 (tNAA)、肌酸 (Cr)、胆碱 (Cho)、肌醇 (m-Ins) 和谷氨酸加谷氨酰胺 (Glx) 水平，有或没有磁共振成像 (MRI) 证据表明内侧颞叶硬化 (MRI)患者和方法：基于强化 24 小时视频脑电图，对 23 名年龄匹配的健康对照者和 26 名连续单侧 TLE 患者进行质子磁共振波谱 ((1)H-MRS) 调查（17 名单侧海马硬化 (HS) MRI-MRI 阳性；9 名 MRI 阴性）。对于统计分析，应用了事后多重比较和 Bonferroni 校正的单向方差分析 (ANOVA)。显着性水平基于 p < 0.05。 结果：与健康对照相比，MRI 阴性患者和 MRI 阳性患者癫痫病灶同侧的平均 tNAA 水平显着降低 (p < 0.001)。 MRI 阳性组中 tNAA 水平最低 (p < 0.001)。统计分析强调了 MRI 阳性和 MRI 阴性患者与健康对照之间存在明确的“tNAA 截止值”（95% 置信区间）。 Glx 和 m-Ins 的平均水平没有显着升高或降低。然而，在个别病例中，MRI 阴性患者的 Glx 显着升高，MRI 阳性患者的 m-Ins 显着升高。结论：MRI 阴性 TLE 患者的 MRS 谱与 MRI 阳性患者 (HS) 不同，tNAA 略有但显着降低。我们的结果揭示了各组之间明显的“tNAA 截止”。 m-Ins 和 Glx 在 TLE 患者病灶检测中的价值仍存在争议。 (C) 2008 年英国癫痫协会。由爱思唯尔有限公司出版。保留所有权利。
Introduction: The objective of this study was to quantitate and compare ipsilateral total N-acetyl aspartate (tNAA), creatine (Cr), choline (Cho), myo-inositol (m-Ins) and glutamate plus glutamine (Glx) levels in the hippocampi of patients with temporal lobe epilepsy (TLE) with and without magnetic resonance imaging (MRI) evidence for mesial temporal sclerosis (MRI positive/negative).Patients and methods: Twenty-three age matched healthy controls and 26 consecutive patients with unilateral TLE, based on intensive 24 h video-EEG, were investigated with proton magnetic resonance spectroscopy ((1)H-MRS) (17 with unilateral hippocampal sclerosis (HS) in MRI-MRI positive; 9 MRI negative). For statistical analysis one-way analysis of variance (ANOVA) with post hoc multiple comparisons and Bonferroni correction was applied. The significance level was based on p < 0.05.Results: The mean tNAA level ipsilateral to the seizure focus was significantly decreased in MRI negative, respectively MRI positive patients in comparison to healthy controls (p < 0.001). The lowest tNAA level was noticed in the MRI positive group (p < 0.001). Statistical analysis highlighted a clear "tNAA cut-off " (95% confidence interval) between MRI positive- and MRI negative patients and healthy controls. Mean level of Glx and m-Ins was not significantly elevated or reduced. However, in individual cases a significant elevation was noticed for Glx in MRI negative patients, respectively for m-Ins in MRI positive patients.Conclusion: MRI negative TLE patients have a different MRS profile than MRI positive patients (HS) with marginal but significant decrease of tNAA. Our results reveal a clear "tNAA cut-off" between the groups. The value of m-Ins and Glx in focus detection in TLE patients remains controversy. (C) 2008 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.