Simister Robert J, McLean Mary A, Barker Gareth J, Duncan John S
Department of Clinical and Experimental Epilepsy, MRI Unit, The National Society for Epilepsy, The Institute of Neurology, University College London, Gerrards Cross, Bucks, UK.
Epilepsy Res. 2009 Feb;83(2-3):168-76. doi: 10.1016/j.eplepsyres.2008.11.006. Epub 2008 Dec 31.
To use proton Magnetic Resonance Spectroscopy (MRS) to measure in vivo temporal lobe GABA and glutamate plus glutamine (GLX) concentrations in patients with temporal lobe epilepsy (TLE) attributable to unilateral hippocampal sclerosis (HS) before and following anterior temporal lobe resection (ATLR).
We obtained quantitative short echo time MRS in both temporal lobes of 15 controls and 16 patients with TLE and HS, and repeat spectra in 10 patients after ATLR. We measured the concentrations of N-acetyl aspartate+N-acetyl aspartyl-glutamate (NAAt), creatine plus phosphocreatine (Cr), and glutamate+glutamine (GLX) using a metabolite-nulled sequence designed to minimize macromolecule artifact. GABA concentrations were measured using a previously described double quantum filter.
In patients with TLE, NAAt/Cr was reduced in ipsilateral and contralateral temporal lobes. No significant variation in GLX/Cr or GABA+/Cr was evident in any group although GABA+/Cr was highest in the ipsilateral temporal lobe in TLE. After ATLR there was a trend to normalization of NAAt/Cr in the contralateral temporal lobe but no change in individual metabolite concentrations, GLX/Cr or GABA+/Cr compared to pre-surgery levels.
Temporal lobe epilepsy was associated with bilateral reduction in NAAt/Cr but not significant abnormality in GABA+/Cr or GLX/Cr. Normalization of NAAt/Cr in the contralateral temporal lobe was seen following successful ATLR.
运用质子磁共振波谱（MRS）测量单侧海马硬化（HS）所致颞叶癫痫（TLE）患者在进行前颞叶切除术（ATLR）前后体内颞叶γ-氨基丁酸（GABA）以及谷氨酸和谷氨酰胺（GLX）的浓度。
我们对15名对照者和16名患有TLE及HS的患者的双侧颞叶进行了定量短回波时间MRS检查，并对10名患者在ATLR术后进行了重复波谱检查。我们使用一种旨在将大分子伪影降至最低的代谢物归零序列来测量N-乙酰天门冬氨酸+N-乙酰天门冬氨酰谷氨酸（NAAt）、肌酸加磷酸肌酸（Cr）以及谷氨酸+谷氨酰胺（GLX）的浓度。使用先前描述的双量子滤波器测量GABA浓度。
在TLE患者中，同侧和对侧颞叶的NAAt/Cr均降低。尽管TLE患者同侧颞叶的GABA+/Cr最高，但在任何组中GLX/Cr或GABA+/Cr均无明显变化。ATLR术后，对侧颞叶的NAAt/Cr有恢复正常的趋势，但与术前水平相比，单个代谢物浓度、GLX/Cr或GABA+/Cr均无变化。
颞叶癫痫与双侧NAAt/Cr降低有关，但GABA+/Cr或GLX/Cr无明显异常。成功进行ATLR后，对侧颞叶的NAAt/Cr恢复正常。
