Duc C O, Trabesinger A H, Weber O M, Meier D, Walder M, Wieser H G, Boesiger P
Institute of Biomedical Engineering and Medical Informatics, University and Swiss Federal Institute of Technology, Zurich.
Magn Reson Imaging. 1998 Oct;16(8):969-79. doi: 10.1016/s0730-725x(98)00123-4.
Hippocampal metabolite concentrations were determined by localized in vivo proton magnetic resonance spectroscopy (1H MRS) in eleven patients suffering from refractory mesial temporal lobe epilepsy (MTLE), as well as in eleven age-matched healthy volunteers, and compared with patient history, postoperative outcome and histopathology. Main results are: 1) In patients, the decrease in N-acetylaspartate (NAA) concentrations was highly significant ipsilateral, and less but still significant contralateral to the electroencephalogram-defined focus, as compared to controls. 2) The decrease in ipsilateral NAA measured preoperatively correlates with the degree of hippocampal sclerosis but 3) does not reliably predict postoperative outcome, although there is a trend toward better outcome in patients with a marked decrease of NAA. 4) Hippocampal NAA decrease (ipsi- and contralateral) is highly correlated with early onset age of epileptic seizures. 5) Among patients with similar onset age in early childhood, there is a strong association between duration of the disease and contralateral (and, though less clear-cut, ipsilateral) NAA loss. These results are concordant with the notion of a generally progressive worsening and complicating course of symptoms in poorly controlled MTLE.
通过局部活体质子磁共振波谱（1H MRS）测定了11例难治性内侧颞叶癫痫（MTLE）患者以及11名年龄匹配的健康志愿者的海马代谢物浓度，并将其与患者病史、术后结果和组织病理学进行了比较。主要结果如下：1）与对照组相比，患者中，N-乙酰天门冬氨酸（NAA）浓度在脑电图定义的病灶同侧显著降低，在对侧降低程度较小但仍显著。2）术前测量的同侧NAA降低与海马硬化程度相关，但3）不能可靠地预测术后结果，尽管NAA显著降低的患者有预后较好的趋势。4）海马NAA降低（同侧和对侧）与癫痫发作的早发年龄高度相关。5）在幼儿期起病年龄相似的患者中，病程与对侧（同侧虽不太明显）NAA丢失之间存在密切关联。这些结果与控制不佳的MTLE症状通常会逐渐恶化并复杂化的观点一致。
