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Changes in glutamate concentration, glucose metabolism, and cerebral blood flow during focal brain cooling of the epileptogenic cortex in humans
Author(s) -
Nomura Sadahiro,
Fujii Masami,
Inoue Takao,
He Yeting,
Maruta Yuichi,
Koizumi Hiroyasu,
Suehiro Eiichi,
Imoto Hirochika,
Ishihara Hideyuki,
Oka Fumiaki,
Matsumoto Mishiya,
Owada Yuji,
Yamakawa Takeshi,
Suzuki Michiyasu
Publication year - 2014
Publication title -
epilepsia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.687
H-Index - 191
eISSN - 1528-1167
pISSN - 0013-9580
DOI - 10.1111/epi.12600
Subject(s) - epilepsy , cerebral blood flow , electrocorticography , glutamate receptor , anesthesia , glycerol , chemistry , blood flow , medicine , endocrinology , psychology , biochemistry , neuroscience , receptor
Summary Objective Recently, focal brain cooling ( FBC ) was proposed as a method for treating refractory epilepsy. However, the precise influence of cooling on the molecular basis of epilepsy has not been elucidated. Thus the aim of this study was to assess the effect of FBC on glutamate (Glu) concentration, cerebral blood flow ( CBF ), and glucose metabolism in patients with intractable epilepsy. Methods Nine patients underwent FBC at 15°C for 30 min prior to cortical resection (n = 6) or hippocampectomy (n = 3). Measurement of metabolites and CBF , as well as electrocorticography ( EC oG), was performed. Results Epileptic discharge ( ED ), as observed by EC oG, disappeared in the cooling period and reappeared in the rewarming period. Glu concentrations were high during the precooling period and were reduced to 51.2% during the cooling period (p = 0.025). Glycerol levels showed a similar decrease (p = 0.028). Lactate concentration was high during the precooling period and was reduced during the cooling period (21.3% decrease; p = 0.005). Glucose and pyruvate levels were maintained throughout the procedure. Changes in CBF were parallel to those observed by EC oG. Significance FBC reduced ED s and concentrations of Glu and glycerol. This demonstrates the neuroprotective effect of FBC . Our findings confirm that FBC is a reasonable and optimal treatment option for patients with intractable epilepsy. A PowerPoint slide summarizing this article is available for download in the Supporting Information section here .