Chu W J, Hetherington H P, Kuzniecky R J, Vaughan J T, Twieg D B, Faught R E, Gilliam F G, Hugg J W, Elgavish G A
Department of Medicine, UAB Epilepsy Center, USA.
Neurology. 1996 Sep;47(3):756-60. doi: 10.1212/wnl.47.3.756.
We performed in vivo 31P NMR spectroscopic studies of human brain on a 4.1 T whole-body NMR system. Based on a control group of 20 healthy volunteers, the normal pHi was 7.05 (SD, 0.06; SEM, 0.01) in the left temporal lobe and 7.04 (SD, 0.04; SEM, 0.01) in the right temporal lobe. We also studied a patient group consisting of 13 individuals with unilateral temporal lobe epilepsy. The mean pHi was 7.02 (SD, 0.04; SEM, 0.01) in the ipsilateral lobe and 7.02 (SD, 0.05; SEM, 0.01) in the contralateral lobe. These results clearly show that no statistically significant difference in pHi is observed between the two lobes, either in normal controls or in patients. Also, no significant pHi difference exists between the control group and the patient group. Lateralization in each of the 13 patients with unilateral epilepsy, based on their individual pHi difference between the ipsilateral lobe and contralateral lobe (delta pHi), showed that three patients were nondiagnostic cases because their delta pHis were not significantly different from zero (< or = 0.02), five patients showed small delta pHis consistent with their clinical lateralization, whereas the remaining five patients showed delta pHi-based lateralization opposite to the clinical findings. These results seem to indicate an essentially random distribution around delta pHi = 0 within a very small experimental error of +/-0.02 pH units. pHi obtained from eight different areas in each of the 13 unilateral patients also did not show any significantly nonzero delta pHi values. These results led to the conclusion that even at the excellent spectral resolution and reproducibility of the 4.1 T machine (typical SD of 0.05 pH units), no significant pHi effect, induced by temporal lobe epilepsy, could be detected. Therefore, in this study, delta pHi does not appear to be a clinically useful tool for the lateralization of epileptic foci in patients with temporal lobe epilepsy.
我们在一台4.1T全身核磁共振系统上对人脑进行了体内31P核磁共振波谱研究。基于20名健康志愿者的对照组，左侧颞叶的正常细胞内pH值（pHi）为7.05（标准差，0.06；标准误，0.01），右侧颞叶为7.04（标准差，0.04；标准误，0.01）。我们还研究了一个由13名单侧颞叶癫痫患者组成的患者组。患侧颞叶的平均pHi为7.02（标准差，0.04；标准误，0.01），对侧颞叶为7.02（标准差，0.05；标准误，0.01）。这些结果清楚地表明，无论是在正常对照组还是患者中，两个颞叶之间在pHi上均未观察到统计学上的显著差异。此外，对照组和患者组之间在pHi上也没有显著差异。根据13名单侧癫痫患者各自患侧颞叶与对侧颞叶之间的pHi差值（ΔpHi）进行的偏侧化分析显示，三名患者为非诊断病例，因为他们的ΔpHi与零无显著差异（≤0.02），五名患者的ΔpHi较小，与他们的临床偏侧化一致，而其余五名患者基于ΔpHi的偏侧化与临床结果相反。这些结果似乎表明，在±0.02pH单位的非常小的实验误差范围内，围绕ΔpHi = 0存在基本随机的分布。从13名单侧患者的每个患者的八个不同区域获得的pHi也未显示任何显著非零的ΔpHi值。这些结果得出的结论是，即使在4.1T机器具有出色的光谱分辨率和可重复性（典型标准差为0.05pH单位）的情况下，也无法检测到由颞叶癫痫引起的显著pHi效应。因此，在本研究中，ΔpHi似乎不是颞叶癫痫患者癫痫灶偏侧化的临床有用工具。
