title: Correlation between 1H MRS and memory before and after surgery in mesial temporal lobe epilepsy with hippocampal sclerosis.
abstract: OBJECTIVE
  Proton magnetic resonance spectroscopy (1H MRS), which can demonstrate neuronal loss and gliosis, may be used as a sensitive tool for lateralization of temporal lobe epilepsy (TLE). Although the correlation between the memory functions and 1H MRS has been investigated, its predictive value after surgery has not been studied previously. This study evaluated memory and 1H MRS values of medically intractable patients with mesial TLE and hippocampal sclerosis (MTLE-HS) before and after selective amygdalohippocampectomy (SAH).
  
  
  METHODS
  Twenty-two patients underwent memory tests and 1H MRS investigation before and 6 months after SAH and were compared with nine control subjects.
  
  
  RESULTS
  The 1H MRS scores were found to be significantly low on the pathological side of the patients. Both right-sided 1H MRS of right TLE and left-sided 1H MRS values of left TLE patients were correlated only with verbal memory scores. Statistical analysis did not reveal any significance for nonverbal memory scores for both TLE groups on either side, which showed no significant correlation between material specificity and 1H MRS findings. Conversely, regression analyses demonstrated that high right- and low left-sided 1H MRS values obtained before surgery may predict a decline in verbal learning scores after surgery.
  
  
  CONCLUSIONS
  1H MRS can be considered as a useful tool to determine the lateralization in patients with MTLE-HS before the surgery. Although only a weak relation exists between the MRS values and memory scores, presurgical MRS scores may be predictive for a possible deterioration in verbal memory after surgery. However, further studies with higher numbers of cases are needed for confirmation of the results.
authors.affiliation: Bakirköy Neurology Center, Istanbul University, Cerrahpaşa Medical Faculty, Istanbul, Turkey.
authors.forename: Lütfü
authors.initials: L
authors.lastname: Hanoğlu
authors.forename: Cigdem
authors.initials: C
authors.lastname: Ozkara
authors.forename: Cahit
authors.initials: C
authors.lastname: Keskinkiliç
authors.forename: Ummühan
authors.initials: U
authors.lastname: Altin
authors.forename: Mustafa
authors.initials: M
authors.lastname: Uzan
authors.forename: Saffet
authors.initials: S
authors.lastname: Tuzgen
authors.forename: Alp
authors.initials: A
authors.lastname: Dinçer
authors.forename: Emin
authors.initials: E
authors.lastname: Ozyurt
mesh_terms: D000293:Adolescent; D000328:Adult; D001224:Aspartic Acid / Q000031:analogs & derivatives* / Q000378:metabolism; D001931:Brain Mapping / Q000379:methods; D002794:Choline / Q000378:metabolism; D003404:Creatinine / Q000378:metabolism; D004569:Electroencephalography; D004833:Epilepsy, Temporal Lobe / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery*; D005260:Female; D007839:Functional Laterality / Q000502:physiology*; D006624:Hippocampus / Q000378:metabolism / Q000473:pathology; D006801:Humans; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D008568:Memory / Q000502:physiology*; D008569:Memory Disorders / Q000175:diagnosis / Q000473:pathology; D008875:Middle Aged; D009483:Neuropsychological Tests / Q000706:statistics & numerical data*; D011182:Postoperative Care; D011300:Preoperative Care; D012598:Sclerosis; D012890:Sleep / Q000502:physiology; D013702:Temporal Lobe / Q000378:metabolism; D014851:Wakefulness / Q000502:physiology
chemical_list: D001224:Aspartic Acid; C000179:N-acetylaspartate; D003404:Creatinine; D002794:Choline