Metabolic and electrophysiological alterations, in subtypes of temporal lobe epilepsy:: A combined proton magnetic resonance spectroscopic imaging and depth electrodes study
Metabolic and electrophysiological alterations, in subtypes of temporal lobe epilepsy:: A combined proton magnetic resonance spectroscopic imaging and depth electrodes study
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DOI：
10.1046/j.1528-1157.2002.05102.x
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发表时间：
2002-10-01
期刊：
影响因子：
5.6
通讯作者：
Cozzone, PJ
中科院分区：
文献类型：
--
作者：
Guye, M;Le Fur, Y;Cozzone, PJ
目的：这项研究比较了代谢区域的改变，其特点是质子磁光谱成像方法：应用H-1-MRSI技术，对颞叶癫痫（TLE）患者进行多个亚型的磁共振成像（MRI）检查，并结合深部电极记录的电生理异常和结构性病变进行分析。25例受试者，包括15例对照组和10例耐药单侧TLE患者，其中9人通过核磁共振成像发现结构异常。所有患者均接受无创术前评估，然后进行立体脑电图（SEEG）。我们进行了一个原始的代谢勘探相结合的两个H-1-MRS成像采集与两个单体素采集（颞极）映射最丰富的感兴趣区域（ROI），包括近中和新皮质定位。选择N-乙酰天冬氨酸/（胆碱+肌酸）比值作为代谢指标。SEEG分析允许将每个ROI分类为电正常或异常（即，参与发作和/或发作间期放电）。结果：在SEEG电生理癫痫异常的所有区域中，N-乙酰天冬氨酸/（胆碱+肌酸）显著低于对照组（p < 0.05）。相比之下，没有任何电生理异常的区域与对照组相比没有代谢差异（p > 0.05），除了一个ROI。致痫区和刺激区的代谢谱没有差异，代谢改变包括病灶，但也延伸到病灶之外。代谢异常的存在，在近中结构是不特定的近中亚型和一般扩展外的近中structures.Conclusions：这些结果表明，代谢异常与发作和发作间期癫痫样活动，而不是在TLE的结构改变。
Purpose: This study compared the metabolic regional alterations, characterized by proton magnetic spectroscopic imaging (H-1-MRSI), with electrophysiological abnormalities recorded by using depth electrodes and with structural lesions, in patients with several subtypes of temporal lobe epilepsy (TLE).Methods: Twenty-five subjects were investigated, including 15 controls and 10 patients with drug-resistant unilateral TLE, nine of whom had structural abnormalities identified by MRI. All patients underwent noninvasive presurgical evaluation and then stereoelectroencephalography (SEEG). We performed an original metabolic exploration combining two H-1-MRS imaging acquisitions associated with two single-voxel acquisitions (temporal poles) to map the most informative regions of interest (ROIs) including mesial and neocortical localizations. The N-acetyl aspartate/(choline+creatine) ratio was chosen as a metabolic index. SEEG analysis allowed the classification of each ROI as electrically normal or abnormal (i.e., involved in ictal and/or interictal discharges). Groups were compared by using a nonparametric Mann-Whitney U test.Results: N-Acetyl aspartate/(choline+creatine) was significantly lower in all regions involved in SEEG electrophysiological epileptic abnormalities than in controls (p < 0.05). In contrast, the regions without any electrophysiological abnormalities were not metabolically different from those in controls (p > 0.05) except in one ROI. No differences between the metabolic profiles of epileptogenic and irritative zones were found. The metabolic alterations included, but also extended beyond, the lesions. The presence of metabolic abnormalities in mesial structures was not specific for the mesial subtype and generally extended Outside the mesial structures.Conclusions: These results indicate that metabolic abnormalities are linked to ictal and interictal epileptiform activities rather than to structural alterations in TLE.