Department of Radiology, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
Epilepsia. 2011 Dec;52(12):2276-84. doi: 10.1111/j.1528-1167.2011.03281.x. Epub 2011 Oct 5.
The aim of this study was to evaluate phospholipid metabolism in patients with malformations of cortical development (MCDs).
Thirty-seven patients with MCDs and 31 control subjects were studied using three-dimensional phosphorus magnetic resonance spectroscopy ((31)P-MRS) at 3.0 T. The voxels in the lesions and in the frontoparietal cortex of the control subjects were compared (the effective volumes were 12.5 cm(3)). Robust quantification methods were applied to fit the time-domain data to the following resonances: phosphoethanolamine (PE); phosphocholine (PC); inorganic phosphate (Pi); glycerophosphoethanolamine (GPE); glycerophosphocholine (GPC); phosphocreatine (PCr); and α-, β-, and γ-adenosine triphosphate (ATP). We also estimated the total ATP (ATP(t) = α-+β-+γ-ATP), phosphodiesters (PDE = GPC+GPE), phosphomonoesters (PME = PE+PC), and the PME/PDE, PCr/ATP(t) and PCr/Pi ratios. The magnesium (Mg(2+)) levels and pH values were calculated based on PCr, Pi, and β-ATP chemical shifts.
Compared to controls and assuming that a p-value < 0.05 indicates statistical significance, the patients with MCDs exhibited significantly lower pH values and higher Mg(2+) levels. In addition, the patients with MCDs had lower GPC and PDE and an increased PME/PDE ratio.
Mg(2+) and pH are important in the regulation of bioenergetics and are involved in many electrical activity pathways in the brain. Our data support the idea that neurometabolic impairments occur during seizure onset and propagation. The GPC, PDE, and PME/PDE abnormalities also demonstrate that there are membrane turnover disturbances in patients with MCDs.
本研究旨在评估皮质发育畸形（MCD）患者的磷脂代谢。
在 3.0T 磁共振上对 37 例 MCD 患者和 31 例对照组进行三维磷磁共振波谱（31P-MRS）检测。将病变区和对照组额顶叶皮质的体素进行比较（有效容积为 12.5cm3）。采用稳健定量方法拟合时域数据到以下共振峰：磷酸乙醇胺（PE）；磷酸胆碱（PC）；无机磷（Pi）；甘油磷酸乙醇胺（GPE）；甘油磷酸胆碱（GPC）；磷酸肌酸（PCr）；和α-、β-、γ-三磷酸腺苷（ATP）。我们还估计了总 ATP（ATP(t) = α-+β-+γ-ATP）、磷酸二酯（PDE = GPC+GPE）、磷酸单酯（PME = PE+PC）以及 PME/PDE、PCr/ATP(t)和 PCr/Pi 比值。根据 PCr、Pi 和β-ATP 化学位移计算镁（Mg2+）水平和 pH 值。
与对照组相比，MCD 患者的 pH 值显著降低，Mg2+水平显著升高（假设 p 值 < 0.05 表示有统计学意义）。此外，MCD 患者的 GPC 和 PDE 水平降低，PME/PDE 比值升高。
Mg2+和 pH 值在生物能量调节中很重要，并且参与大脑中的许多电活动途径。我们的数据支持癫痫发作起始和传播过程中存在神经代谢异常的观点。GPC、PDE 和 PME/PDE 的异常也表明 MCD 患者存在膜周转率紊乱。
