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In vivo measurements of glutamine+ glutamate (Glx) and N‐acetyl aspartate (NAA) levels in human partial epilepsy
Author(s) -
Savic I.,
Thomas A. M.,
Ke Y.,
Curran J.,
Fried Itzhak,
Engel Jerome
Publication year - 2000
Publication title -
acta neurologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.967
H-Index - 95
eISSN - 1600-0404
pISSN - 0001-6314
DOI - 10.1034/j.1600-0404.2000.102003179.x
Subject(s) - epilepsy , creatine , glutamine , glutamate receptor , choline , medicine , endocrinology , chemistry , neuroscience , biology , biochemistry , receptor , amino acid
Objective – To investigate whether cerebral levels of N‐acetyl aspartate (NAA), and glutamine+glutamate (Glx), are interictally altered in the epileptogenic regions of patients with partial seizures. Material and methods – NAA, Glx, creatine (Cr), choline (Cho) and myo‐inositol (mI) was measured in 28 patients with partial epilepsy and 10 healthy controls using localized 1 H magnetic resonance spectroscopy. According to the multimethodological consensus, the epileptogenic region was mesial temporal in 18 and neocortical in 10 patients. Results – The Glx/NAA and Glx/Cr ratios in epileptogenic regions were higher, and the NAA/Cr ratios lower than in the homologous regions ( P =0.013, P =0.002 and P <0.0001). Applying the 95% confidence interval of controls, 17 of the 20 mesial temporal epileptogenic regions were correctly identified by an increased Glx/NAA and 15 of 20 by a decreased NAA/Cr ratio. Among patients with neocortical epilepsy the Glx/NAA ratio was increased in 8 of the 10 epileptogenic regions, whereas the NAA/Cr ratio was decreased in three. Conclusion – Both Glx and NAA are useful to identify the epileptogenic zone. The Glx/NAA ratios may be particularly useful to indentify neocortical epileptogenic regions.