Document Detail


Metabolic characteristics of cortical malformations causing epilepsy.
MedLine Citation:
PMID:  15868069     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: Cortical malformations (CMs) are increasingly recognized as the epileptogenic substrate in patients with medically refractory neocortical epilepsy (NE). The aim of this study was to test the hypotheses that: 1. CMs are metabolically heterogeneous. 2. The structurally normal appearing perilesional zone is characterized by similar metabolic abnormalities as the CM.
METHODS: Magnetic resonance spectroscopic imaging (MRSI) in combination with tissue segmentation was performed on eight patients with NE and CMs and 19 age matched controls. In controls, NAA, Cr, Cho,NAA/Cr and NAA/Cho of all voxels of a given lobe were expressed as a function of white matter content and thresholds for pathological values determined by calculating the 95% prediction intervals. These thresholds were used to identify metabolically abnormal voxels within the CM and in the perilesional zone.
RESULTS: 30% of all voxels in the CMs were abnormal, most frequently because of decreases of NAA or increases of Cho. Abnormal voxels tended to form metabolically heterogeneous clusters interspersed in metabolically normal regions. Furthermore, 15% of all voxels in the perilesional zone were abnormal, the most frequent being decreases of NAA and Cr.
CONCLUSION: In CMs metabolically normal regions are interspersed with metabolically heterogeneous abnormal regions. Metabolic abnormalities in the perilesional zone share several characteristics of CMs and might therefore represent areas with microscopic malformations and/or intrinsic epileptogenicity.
Authors:
S G Mueller; K D Laxer; J A Barakos; N Cashdollar; D L Flenniken; P Vermathen; G B Matson; M W Weiner
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.     Date:  2005-04-29
Journal Detail:
Title:  Journal of neurology     Volume:  252     ISSN:  0340-5354     ISO Abbreviation:  J. Neurol.     Publication Date:  2005 Sep 
Date Detail:
Created Date:  2005-09-19     Completed Date:  2005-12-07     Revised Date:  2011-09-26    
Medline Journal Info:
Nlm Unique ID:  0423161     Medline TA:  J Neurol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  1082-92     Citation Subset:  IM    
Affiliation:
Dept. of Veterans Affairs (DVA), Medical Center, Magnetic Resonance Spectroscopy Unit, San Francisco, CA 94115, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aspartic Acid / analogs & derivatives,  metabolism
Cerebral Cortex / abnormalities*,  metabolism*
Choline / metabolism
Creatine / metabolism
Epilepsy / physiopathology*
Humans
Image Processing, Computer-Assisted
Magnetic Resonance Imaging
Magnetic Resonance Spectroscopy
Phosphocreatine / metabolism
Grant Support
ID/Acronym/Agency:
R01 NS031966-14/NS/NINDS NIH HHS; R01-NS31966/NS/NINDS NIH HHS
Chemical
Reg. No./Substance:
56-84-8/Aspartic Acid; 57-00-1/Creatine; 62-49-7/Choline; 67-07-2/Phosphocreatine; 997-55-7/N-acetylaspartate
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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