MRS LOCALIZATION OF ADULTS/PEDIATRIC EPILEPTIC FOCI

成人/儿童癫痫病灶的 MRS 定位

• 批准号: 2892409
• 负责人: THIAN C NG
• 金额: $ 28.61万
• 依托单位: CLEVELAND CLINIC FOUNDATION
• 依托单位国家: 美国
• 财政年份: 1998
• 资助国家: 美国
• 起止时间: 1998-04-03 至 2000-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2892409
• 关键词: brain disorder diagnosis; brain imaging /visualization /scanning; brain metabolism; choline; clinical research; creatine; electroencephalography; epilepsy; hippocampus; histopathology; human subject; lactates; magnetic resonance imaging; memory; neuropsychological tests; neurosurgery; nuclear magnetic resonance spectroscopy; postoperative complications

DESCRIPTION (Adapted from Applicant's Abstract): The proposal is designed to use proton magnetic resonance spectroscopic imaging (MRSI) in patients with drug-refractory surgically treatable focal temporal lobe epilepsy (TLE) to determine if MRSI spectra of localized abnormal brain metabolites are associated with: 1) the site(s) of maximal electroencephalographic (EEG) epileptiform activity, as determined by video-EEG monitoring of conventional scalp-sphenoidal or by depth-electrode recordings, 2) post-resection histopathologic tissue abnormalities in the MRSI abnormal region of interest (ROI); and 3) post-resection measurement of seizure control as predicted by the locations and extents of qualified anomalies in MSRI metabolites; 4) baseline of functional status of memory and the degree of post-surgery memory loss as determined by IAP and neuropsychological measures; 5) the study of the mechanism of correlations of MRS metabolite disturbances in hippocampal formation (HF) to the HF neuron cell loss (by histopathology) and HF atrophy (by MRI-volumetry). There is a history of using brain imaging in focal epilepsy, to lateralize temporal lobe epilepsy by fluoro-deoxyglucose positron emission tomography (18F-PET), and gross anatomic pathologies by magnetic resonance imaging (MRI). However, no imaging technique has yet actually tested if more subtle but well-established abnormalities in an epileptic focus can be reliably imaged, such as alterations in various neurochemicals and changes in their concentrations (e.g. glucose-lactate production, high-energy substrate creatine, or membrane substrate choline). Pediatric and adult patients with temporal lobe epilepsy (TLE) will be imaged interictally and early postictally by MRSI and MRS. Simultaneous acquisitions of two-dimensional double-spin echo (echo-time 135 msec.) MRSI and conventional MRI (T1, T2 and thin-slice Turbo-Flash) will provide feasibility of in situ metabolic maps for correlation to EEG seizure-onset profiles, and to the surgical regions, and pathoanatomic region(s) studied. Concentrations of and ratios between N-acetyl-aspertate (NAA), choline, (Cho), Creatine (Cr), and Lactate (Lac) will allow multivariate statistical tests with other variables to determine when MSRI of certain chemical substrates may be characteristic of epileptogenic areas of hippocampal sclerosis (neuronal loss and gliosis) and ultimately of seizure control after resection. This research is of great importance to the development of reliable and sensitive diagnostic methods for isolating surgically treatable focal epilepsies as well as the more difficult surgical treatment of childhood focal epilepsy, both of which afflict about 1% of Americans.

描述（改编自申请人的摘要）：该提案的设计 对患者使用质子磁共振波谱成像 (MRSI) 药物难治性可手术治疗的局灶性颞叶癫痫 (TLE) 确定局部异常脑代谢物的 MRSI 谱是否 与以下因素相关：1) 最大脑电图 (EEG) 部位 癫痫样活动，通过传统的视频脑电图监测确定 头皮蝶骨或深度电极记录，2) 切除后 MRSI 异常感兴趣区域的组织病理学组织异常 （投资回报率）； 3) 切除后癫痫发作控制的测量，如预测的那样 MSRI 代谢物中合格异常的位置和范围； 4） 记忆功能状态基线和术后程度 由 IAP 和神经心理学测量确定的记忆丧失； 5) 的 MRS代谢紊乱相关机制的研究 海马形成 (HF) 到 HF 神经元细胞丢失（通过组织病理学） 和 HF 萎缩（通过 MRI 容积测定）。 有使用大脑的历史 局灶性癫痫的成像，通过以下方式将颞叶癫痫偏侧化 氟脱氧葡萄糖正电子发射断层扫描 (18F-PET) 和总体 通过磁共振成像 (MRI) 进行解剖病理学检查。 然而，没有 成像技术尚未实际测试是否更微妙，但 可以可靠地对癫痫病灶中已确定的异常进行成像， 例如各种神经化学物质的改变及其 浓度（例如葡萄糖-乳酸生产、高能底物 肌酸或膜底物胆碱）。 患有颞叶癫痫 (TLE) 的儿童和成人患者将接受 发作间期和发作后早期通过 MRSI 和 MRS 进行成像。 同时 二维双自旋回波采集（回波时间 135 毫秒）MRSI 传统 MRI（T1、T2 和薄层 Turbo-Flash）将提供 原位代谢图与脑电图癫痫发作相关的可行性 轮廓、手术区域和所研究的病理解剖区域。 N-乙酰天冬氨酸 (NAA)、胆碱、 (Cho)、肌酸 (Cr) 和乳酸 (Lac) 将允许进行多变量统计 使用其他变量进行测试以确定某些化学品的 MSRI 何时 基质可能是海马致癫痫区域的特征 硬化（神经元丢失和神经胶质增生）并最终控制癫痫发作 切除后。 这项研究对于我国的发展具有重要意义 用于分离可手术治疗的可靠且灵敏的诊断方法 局灶性癫痫以及更困难的手术治疗 儿童局灶性癫痫，这两种疾病均困扰着约 1% 的美国人。