Mueller S G, Weber O M, Duc C O, Meier D, Russ W, Boesiger P, Wieser H G
Department of Neurology, University Hospital, Frauenklinikstr 26, CH-8091 Zurich.
Eur J Neurol. 2003 Jan;10(1):45-52. doi: 10.1046/j.1468-1331.2003.00506.x.
The new antiepileptic drug vigabatrin (VGB) increases gamma-aminobutyric acid (GABA) in the brain. We compared GABA+/Cr signals measured focus-near and focus-distant and correlated it with the degree of response to VGB. Brain GABA+/Cr signals were measured in 17 epileptic patients in structurally normal appearing tissue by nuclear proton magnetic resonance (1H-NMR) spectroscopy using a special editing sequence for GABA. In 11 patients the measurements were done in brain areas distant to focus and in six near to focus. Full-responders (seizure reduction of >or=50% at the end of the treatment phase) and partial-responders (seizure reduction of >or=50% at the end of the first month of treatment but <or=50% at end of treatment) had lower GABA+/Cr signals in the hemisphere with the epileptogenic focus and increases of the GABA+/Cr signals with VGB. Non-responders (seizure reduction of <or=50%) had no side difference in the GABA+/Cr signals before treatment and no increase during treatment. These observations were made in structurally normal appearing tissue near to the focus and distant to the focus. A side difference in brain GABA+/Cr signal between the epileptogenic and non-epileptogenic hemisphere before VGB treatment correlates with an improved seizure control under VGB treatment regardless whether the measurement is done focus-near or focus-distant.
新型抗癫痫药物氨己烯酸（VGB）可增加大脑中的γ-氨基丁酸（GABA）。我们比较了在癫痫病灶附近和远离病灶处测得的GABA+/Cr信号，并将其与对VGB的反应程度相关联。通过使用针对GABA的特殊编辑序列的核磁共振氢谱（1H-NMR）光谱法，在17例癫痫患者结构正常的脑组织中测量了脑GABA+/Cr信号。11例患者在远离病灶的脑区进行测量，6例在靠近病灶的脑区进行测量。完全缓解者（治疗阶段结束时癫痫发作减少≥50%）和部分缓解者（治疗第一个月末癫痫发作减少≥50%但治疗结束时≤50%）在有癫痫病灶的半球中GABA+/Cr信号较低，且VGB治疗后GABA+/Cr信号升高。无反应者（癫痫发作减少≤50%）治疗前GABA+/Cr信号无差异，治疗期间也无升高。这些观察结果是在靠近病灶和远离病灶的结构正常的脑组织中得出的。VGB治疗前癫痫病灶半球和非癫痫病灶半球之间脑GABA+/Cr信号的差异与VGB治疗下癫痫发作控制的改善相关，无论测量是在病灶附近还是远离病灶处进行。
