Document Detail


Temporal lobe magnetic resonance spectroscopic imaging following selective amygdalohippocampectomy for treatment-resistant epilepsy.
MedLine Citation:
PMID:  15932349     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: Magnetic resonance spectroscopic imaging (MRSI) may show circumscribed or extensive decreased brain N-acetyl aspartate (NAA)/creatine and phosphocreatine (Cr) in epilepsy patients. We compared temporal lobe MRSI in patients seizure-free (SzF) or with persistent seizures (PSz) following selective amygdalohippocampectomy (SAH) for medically intractable mesial temporal lobe epilepsy (mTLE). We hypothesized that PSz patients had more extensive temporal lobe metabolite abnormalities than SzF patients. MATERIALS AND METHODS: MRSI was used to study six regions of interest (ROI) in the bilateral medial and lateral temporal lobes in 14 mTLE patients following SAH and 11 controls. RESULTS: PSz patients had more temporal lobe ROI with abnormally low NAA/Cr than SzF patients, including the unoperated hippocampus and ipsilateral lateral temporal lobe. CONCLUSION: Postoperative temporal lobe MRSI abnormalities are more extensive if surgical outcome following SAH is poor. MRSI may be a useful tool to improve selection of appropriate candidates for SAH by identifying patients requiring more intensive investigation prior to epilepsy surgery. Future prospective studies are needed to evaluate the utility of MRSI, a predictor of successful outcome following SAH.
Authors:
D C Spencer; J Szumowski; D F Kraemer; P Y Wang; K J Burchiel; D M Spielman
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Acta neurologica Scandinavica     Volume:  112     ISSN:  0001-6314     ISO Abbreviation:  Acta Neurol. Scand.     Publication Date:  2005 Jul 
Date Detail:
Created Date:  2005-06-03     Completed Date:  2005-08-18     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0370336     Medline TA:  Acta Neurol Scand     Country:  Denmark    
Other Details:
Languages:  eng     Pagination:  6-12     Citation Subset:  IM    
Copyright Information:
Copyright Blackwell Munksgaard 2005.
Affiliation:
Department of Neurology, Oregon Health and Science University, Portland, OR 97239, USA. spencerd@ohsu.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Amygdala / metabolism*,  physiopathology,  surgery
Aspartic Acid / analogs & derivatives*,  analysis,  metabolism
Brain Chemistry / physiology*
Creatine / analysis,  metabolism
Epilepsy, Temporal Lobe / diagnosis*,  metabolism*,  surgery
Female
Hippocampus / metabolism*,  physiopathology,  surgery
Humans
Magnetic Resonance Spectroscopy
Male
Middle Aged
Neocortex / metabolism,  physiopathology
Neurosurgical Procedures
Phosphocreatine / analysis,  metabolism
Predictive Value of Tests
Reference Values
Treatment Outcome
Grant Support
ID/Acronym/Agency:
CA48269/CA/NCI NIH HHS; RR09784/RR/NCRR NIH HHS
Chemical
Reg. No./Substance:
56-84-8/Aspartic Acid; 57-00-1/Creatine; 67-07-2/Phosphocreatine; 997-55-7/N-acetylaspartate

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