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1H NMR CHEMICAL SHIFT IMAGING IN TEMPORAL LOBE EPILEPSY

颞叶癫痫的 1H NMR 化学位移成像

基本信息

批准号：
2910742
负责人：
Hoby P Hetherington
金额：
$ 17.73万
依托单位：
BROOKHAVEN SCIENCE ASSOC-BROOKHAVEN LAB
依托单位国家：
美国
项目类别：
财政年份：
1995
资助国家：
美国
起止时间：
1995-12-15 至 2000-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/2910742
关键词：
aspartate brain disorder diagnosis brain metabolism cerebral dominance clinical research creatine diagnosis design /evaluation glutamates glutamine human subject noninvasive diagnosis nuclear magnetic resonance spectroscopy partial seizure temporal lobe /cortex disorder

项目摘要

DESCRIPTION: (adapted from Applicant's Abstract) Epilepsy is one of the most common neurological disorders, affecting one to two million Americans. For some 100,000-200,000 Americans its debilitating symptoms cannot be overcome through medication. In some of these patients, surgery is highly effective, however available non-invasive diagnostic procedures such as MRI, PET and scalp EEG provide diagnostic localization in less than 70 percent of the patients with partial seizures. Intracranial EEG measurements while highly accurate are invasive, require hospitalization and are costly. However MR spectroscopy examinations using the ratio of N-acetyl aspartate (NA)/creatine (CR) have recently proven to be highly effective in lateralizing epileptogenic tissue. These studies have used asymmetries in the NA/CR ratio between the temporal lobes as the criteria for determining the seizure focus. Unfortunately this type of analysis precludes the use of this test to: 1) evaluate the patient for evidence of bilateral disease, 2) determine the spatial extent of the disease and 3) determine which compounds are actually changing (CR or NA or both). Therefore the goal of this proposal is to: 1) extend, apply and evaluate 1H CSI methods which permit the localization of the seizure focus based on absolute comparisons to parameters determined from healthy tissue, thereby permitting evaluation of the presence of bilateral disease; 2) determine the origin of the ratio changes seen 3) evaluate the use of other metabolic parameters, specifically glutamate and glutamine content as indicators for the localization of the seizure focus and 4) evaluate the sensitivity and specificity of these methods in comparison to scalp EEG and MRI at 1.5T. These studies will be performed at 4.1T on a whole body imaging/spectroscopy system. Although the number of these systems are extremely limited, the advantages in terms of increased S/N, spatial resolution and spectral resolution, makes it an attractive tool for investigating these changes. Successful validation of this methodology and its subsequent translation to lower field strengths, would provide a highly accurate, non-invasive and cost effective mechanism for pre- surgical planning.

描述：（改编自申请人的摘要）癫痫是一种最常见的神经系统疾病，影响一到两百万人美国人对于大约10万到20万美国人来说，不能通过药物治疗。在这些病人中，外科手术是非常有效的，然而可用的非侵入性诊断诸如MRI、PET和头皮EEG的程序提供诊断定位不到70%的部分性癫痫患者颅内EEG测量虽然高度准确，但却是侵入性的，需要住院治疗并且费用昂贵。然而，使用N-乙酰天冬氨酸（NA）/肌酸（CR）比值进行的检查最近被证明是非常有效的偏侧癫痫组织.这些研究使用了NA/CR比率的不对称性，颞叶作为确定癫痫发作病灶的标准。不幸的是，这种类型的分析排除了使用该测试： 1)评估患者是否有双侧疾病的证据，2）确定疾病的空间范围和3）确定哪些化合物是实际变化（CR或NA或两者）。因此，建议是：1）扩展，应用和评估1H CSI方法，允许基于绝对的癫痫病灶定位与从健康组织确定的参数进行比较，从而允许评估双侧疾病的存在; 2）确定所见比率变化的起源3）评价其他代谢参数，特别是谷氨酸和谷氨酰胺含量，用于癫痫病灶定位的指标和4）评估与头皮EEG相比，这些方法的灵敏度和特异性和1.5T的MRI。这些研究总体上将在4.1T下进行身体成像/光谱系统。虽然这些系统的数量在增加S/N、空间分辨率和空间分辨率方面，分辨率和光谱分辨率，使其成为一个有吸引力的工具，调查这些变化。成功验证该方法以及其随后向较低场强的转换，将提供一种高度准确、非侵入性和成本效益高的机制，手术计划