Department of Neurosurgery, Fujita Health University, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi, 470-1192, Japan.
Department of Radiology, Fujita Health University, Toyoake, Aichi, Japan.
Sci Rep. 2021 Apr 12;11(1):7927. doi: 10.1038/s41598-021-86487-6.
Seizures are common in patients with gliomas; however, the mechanisms of epileptogenesis in gliomas have not been fully understood. This study hypothesized that analyzing quantified metabolites using magnetic resonance spectroscopy (MRS) might provide novel insights to better understand the epileptogenesis in gliomas, and specific metabolites might be indicators of preoperative seizures in gliomas. We retrospectively investigated patient information (gender, age at diagnosis of tumor, their survival time) and tumor information (location, histology, genetic features, and metabolites according to MRS) in patients with gliomas. The data were correlated with the incidence of seizure and analyzed statistically. Of 146 adult supratentorial gliomas, isocitrate dehydrogenase (IDH) mutant tumors significantly indicated higher incidence of preoperative seizures than IDH wild-type gliomas. However, MRS study indicated that glutamate concentration in IDH wild-type gliomas was higher than that in IDH mutant gliomas. Glutamate was not associated with high frequency of preoperative seizures in patients with gliomas. Instead, increased total N-acetyl-L-aspartate (tNAA) was significantly associated with them. Moreover, multivariable analysis indicated that increased level of tNAA was an independent predictor of preoperative seizures. According to MRS analysis, tNAA, rather than glutamate, might be a useful to detect preoperative seizures in patient with supratentorial gliomas.
癫痫发作在脑胶质瘤患者中很常见；然而，脑胶质瘤致痫机制尚未完全阐明。本研究假设，使用磁共振波谱分析（MRS）对量化代谢物进行分析，可能为更好地理解脑胶质瘤的致痫机制提供新的见解，并且特定的代谢物可能是脑胶质瘤术前癫痫发作的指标。我们回顾性调查了脑胶质瘤患者的患者信息（性别、肿瘤诊断时的年龄、生存时间）和肿瘤信息（位置、组织学、遗传特征和 MRS 依据的代谢物）。将数据与癫痫发作的发生率相关联，并进行统计学分析。在 146 例成人幕上脑胶质瘤中，异柠檬酸脱氢酶（IDH）突变型肿瘤的术前癫痫发作发生率明显高于 IDH 野生型脑胶质瘤。然而，MRS 研究表明，IDH 野生型脑胶质瘤中的谷氨酸浓度高于 IDH 突变型脑胶质瘤。谷氨酸与脑胶质瘤患者术前癫痫发作的高频率无关。相反，总 N-乙酰-L-天冬氨酸（tNAA）的增加与它们显著相关。此外，多变量分析表明，tNAA 水平升高是术前癫痫发作的独立预测因子。根据 MRS 分析，tNAA 而不是谷氨酸，可能是检测幕上脑胶质瘤患者术前癫痫发作的有用指标。
