MRS LOCALIZATION OF ADULTS/PEDIATRIC EPILEPTIC FOCI

成人/儿童癫痫病灶的 MRS 定位

• 批准号: 6287496
• 负责人: THIAN C NG
• 金额: $ 29.39万
• 依托单位: UNIVERSITY OF ALABAMA AT BIRMINGHAM
• 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 2003-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6287496
• 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(改编自申请者摘要)：方案设计 质子磁共振波谱成像(MRSI)在患者中的应用 伴药物难治性手术治疗的局灶性颞叶癫痫(TLE) 以确定局部异常脑代谢产物的磁共振波谱是否 与：1)最大脑电(S)部位 由常规视频脑电监测确定的癫痫样活动 头皮-蝶骨或深部电极记录，2)术后 磁共振成像异常感兴趣区的组织病理学异常 (ROI)；以及3)如以下预测的癫痫发作控制的切除后测量 MSRI代谢物合格异常的位置和程度；4) 术后记忆功能状态和程度的基线 由IAP和神经心理学测量确定的记忆丧失；5) MRS代谢紊乱相关性机制的研究 海马结构(HF)对HF神经元细胞丢失的影响(组织病理学) 和HF萎缩(MRI-容量测量法)。有使用大脑的历史 局灶性癫痫的影像诊断--以颞叶癫痫为例 氟脱氧葡萄糖正电子发射断层扫描(18F-PET) 磁共振成像(MRI)的解剖病理学。然而，没有 成像技术实际上已经测试了更微妙的 癫痫灶中公认的异常可以可靠地成像， 例如各种神经化学物质的改变和它们的 浓度(例如，葡萄糖-乳酸生产、高能底物 肌酸，或膜底物胆碱)。 儿童和成人的颞叶癫痫(TLE)患者将 MRSI和MRS同时对发病间期和发病后早期进行成像 采集二维双自旋回波(回波时间135毫秒)MRSI 而常规MRI(T1、T2和薄层Turbo-Flash)将提供 原位代谢图与脑电癫痫发作相关性的可行性 并对手术部位和病理解剖部位(S)进行了研究。 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 用其他变量进行测试，以确定某些化学品的MSRI 底物可能是海马区致痫的特征 硬化症(神经元丢失和胶质细胞增生症)和最终的癫痫控制 切除后。这项研究对我国农业产业化的发展具有重要意义。 可靠和敏感的诊断方法用于分离出可手术治疗的 局灶性癫痫以及更困难的外科治疗 儿童局灶性癫痫，这两种疾病都困扰着大约1%的美国人。