EPILEPSY

这个子项目是许多研究子项目中的一个 由NIH/NCRR资助的中心赠款提供的资源。子项目和 研究者（PI）可能从另一个NIH来源获得了主要资金， 因此可以在其他CRISP条目中表示。所列机构为 研究中心，而研究中心不一定是研究者所在的机构。 在选定的难治性颞叶癫痫患者（药物控制不佳的癫痫）中，手术可以提供有效的治疗选择。 然而，手术患者的选择通常受到可用于识别癫痫病灶的诊断程序的限制。 用于定侧病灶的程序包括常规EEG和视频EEG监测、磁共振成像（MRI）、正电子发射断层扫描（PET）和通过手术将EEG电极放置在颅内。 本研究的目的是：1）评价与颞叶癫痫相关的生化变化; 2）评价NMR光谱成像（NMRSI）在定位和定侧难治性癫痫患者致痫组织中的灵敏度和特异性。 将使用4 T全身NMR系统收集数据。 在采集期间，除了保持静止外，患者不需要采取任何特定行动。 将分析化学成分数据是否与对照值发生变化（在健康个体中获得）以鉴定具有代谢异常的区域，包括：N-乙酰基天冬氨酸的减少，（神经元功能障碍/丧失的标志物）;总肌酸增加（神经胶质与神经元比率增加的标志物），谷氨酸盐增加（主要的兴奋性神经递质）磷酸肌酸和ATP减少（脑能量储存）和降低的氧化代谢（13 C标记的葡萄糖转化为谷氨酸的速率）。 该数据将与可用的常规临床数据（EEG、神经心理测试、视频EEG监测和手术结果）相关联，以评估灵敏度和特异性。 如果成功的话，这种方法可以取代在特别复杂的研究中进行侵入性颅内电极研究的需要。 这反过来将为颞叶手术的规划提供一种更具成本效益和更安全的方法。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. In selected patients with intractable temporal lobe epilepsy, (epilepsies which are poorly controlled by medication), surgery can provide an effective therapeutic option. However, the selection of a patient for surgery is typically limited by the diagnostic procedures available to identify the epileptic focus. The procedures for lateralizing the focus include routine EEG and Video-EEG monitoring, magnetic resonance imaging (MRI), positron emission tomography (PET) and the intracranial placement of EEG electrodes by surgery. The goals of this study are to 1) evaluate the biochemical changes associated with temporal lobe epilepsy and 2) evaluate the sensitivity and specificity of NMR Spectroscopic Imaging (NMRSI) in localizing and lateralizing epileptogenic tissue in patients with intractable epilepsy. Data will be collected using a 4T whole-body NMR system. During the acquisitions, no specific actions are required on part of the patient other than to remain still. The chemical composition data will be analyzed for alterations from control values (obtained in healthy individuals) to identify regions with metabolic abnormalities including: decreases in N-acetyl aspartate, (a marker of neuronal dysfunction/loss); increases in total creatine (marker for increased glia to neuron ratios), increases in glutamate (the primary excitatory neurotransmitter) decreases in phophocreatine and ATP (cerebral energy stores) and decreased oxidative metabolism (rate of incorporations of 13C labeled glucose into glutamate). This data will be correlated with available routine clinical data (EEG, neuro-psychological testing, video-EEG monitoring and surgical outcome) to assess the sensitivity and specificity. If successful, this methodology may replace the need for carrying out invasive intracranial electrode studies in particularly complex studies. This in turn would provide a more cost effective and safer method for planning in temporal lobe surgery.