Davis Kathryn Adamiak, Nanga Ravi Prakash Reddy, Das Sandhitsu, Chen Stephanie H, Hadar Peter N, Pollard John R, Lucas Timothy H, Shinohara Russell T, Litt Brian, Hariharan Hari, Elliott Mark A, Detre John A, Reddy Ravinder
Penn Epilepsy Center, Department of Neurology, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA.
Center for Magnetic Resonance & Optical Imaging, Department of Radiology, University of Pennsylvania, Philadelphia, PA 19104, USA.
Sci Transl Med. 2015 Oct 14;7(309):309ra161. doi: 10.1126/scitranslmed.aaa7095.
When neuroimaging reveals a brain lesion, drug-resistant epilepsy patients show better outcomes after resective surgery than do the one-third of drug-resistant epilepsy patients who have normal brain magnetic resonance imaging (MRI). We applied a glutamate imaging method, GluCEST (glutamate chemical exchange saturation transfer), to patients with nonlesional temporal lobe epilepsy based on conventional MRI. GluCEST correctly lateralized the temporal lobe seizure focus on visual and quantitative analyses in all patients. MR spectra, available for a subset of patients and controls, corroborated the GluCEST findings. Hippocampal volumes were not significantly different between hemispheres. GluCEST allowed high-resolution functional imaging of brain glutamate and has potential to identify the epileptic focus in patients previously deemed nonlesional. This method may lead to improved clinical outcomes for temporal lobe epilepsy as well as other localization-related epilepsies.
当神经影像学检查发现脑部病变时，耐药性癫痫患者在接受切除性手术后的预后要优于三分之一脑部磁共振成像（MRI）正常的耐药性癫痫患者。我们基于传统MRI，将一种谷氨酸成像方法，即GluCEST（谷氨酸化学交换饱和转移）应用于非病变性颞叶癫痫患者。在所有患者中，GluCEST在视觉和定量分析上均能正确地对颞叶癫痫病灶进行定位。部分患者和对照组可获得的磁共振波谱证实了GluCEST的结果。两侧海马体积无显著差异。GluCEST能够对脑谷氨酸进行高分辨率功能成像，并且有潜力识别先前被认为无病变的患者的癫痫病灶。这种方法可能会改善颞叶癫痫以及其他与定位相关癫痫的临床预后。
