Reduced extrahippocampal NAA in mesial temporal lobe epilepsy.
OBJECTIVE
Structural and metabolic abnormalities in the hippocampal region in medial temporal lobe epilepsy (mTLE) are well described; less is known about extrahippocampal changes. This study was designed to characterize extrahippocampal metabolic abnormalities in mTLE with magnetic resonance spectroscopy in combination with tissue segmentation and volumetry of gray and white matter.


METHODS
Multislice magnetic resonance spectroscopic imaging (1H-MRSI) in combination with tissue segmentation was performed on 16 patients with mTLE and 12 age-matched healthy volunteers. The data were analyzed by using a regression-analysis model that estimated the metabolite concentrations in 100% cortical gray and 100% white matter in the frontal lobe and nonfrontal brain. The segmented image was used to calculate the fraction of gray and white matter in these regions.


RESULTS
mTLE had significantly lower N-acetyl aspartate (NAA) in ipsi- and contralateral frontal gray (p = 0.03) and in ipsi- and contralateral nonfrontal white matter (p = 0.008) compared with controls. Although there were no associated volumetric deficits in frontal gray and white matter, ipsilateral nonfrontal gray matter (p = 0.003) was significantly smaller than that in controls.


CONCLUSIONS
mTLE is associated with extrahippocampal metabolic abnormalities and volumetric deficits, but these do not necessarily affect the same regions.
D000328:Adult; D001224:Aspartic Acid / Q000031:analogs & derivatives* / Q000378:metabolism*; D001921:Brain / Q000033:anatomy & histology / Q000378:metabolism* / Q000503:physiopathology; D004569:Electroencephalography; D004833:Epilepsy, Temporal Lobe / Q000175:diagnosis* / Q000378:metabolism / Q000503:physiopathology; D005260:Female; D005625:Frontal Lobe / Q000033:anatomy & histology / Q000378:metabolism / Q000503:physiopathology; D007839:Functional Laterality; D006801:Humans; D008279:Magnetic Resonance Imaging; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D008875:Middle Aged; D014055:Tomography, Emission-Computed
D001224:Aspartic Acid; C000179:N-acetylaspartate