Regional energetic dysfunction in hippocampal epilepsy.
OBJECTIVE
There is increasing evidence for a dysfunctional metabolic network in human mesial temporal lobe epilepsy (MTLE). To further describe this, we evaluated the bioenergetic status in unilateral MTLE inter-regionally and in relation to neuropathology.


METHODS
We used whole brain high field (4 T) 31P MR spectroscopic imaging to determine in vivo PCr and ATP, studying n=22 patients (all candidates for hippocampal resection) and n=14 control volunteers. The degree of bioenergetic impairment was assessed by calculating the ratio of PCr to ATP.


RESULTS
Compared to controls, patients demonstrated significant decreases in PCr/ATP from the ipsilateral amygdala and pes (0.84 +/- 0.14, 0.87 +/- 0.10, respectively, patients vs 0.97 +/- 0.15, 0.98 +/- 0.16, controls). In patients, the ipsilateral thalamic energetics positively correlated with contralateral hippocampal energetics. In addition, the ipsilateral thalamic and striatal energetics negatively correlated with hippocampal total glial counts.


CONCLUSIONS
These data are consistent with a view that in MTLE, the bilateral hippocampi, ipsilateral thalamus and striatum are linked in their energetic depression, possibly reflecting the propagation of seizures throughout the brain.
Pan
J W
JW
Department of Neurology, Albert Einstein College of Medicine, Bronx, NY 10461, USA. jpan@aecom.yu.edu
Kim
J H
JH
Cohen-Gadol
A
A
Pan
C
C
Spencer
D D
DD
Hetherington
H P
HP
D000255:Adenosine Triphosphate / Q000378:metabolism*; D000293:Adolescent; D000328:Adult; D001923:Brain Chemistry; D016022:Case-Control Studies; D003342:Corpus Striatum / Q000378:metabolism / Q000473:pathology; D004827:Epilepsy / Q000503:physiopathology*; D005260:Female; D006624:Hippocampus / Q000378:metabolism* / Q000473:pathology*; D006801:Humans; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D008875:Middle Aged; D010725:Phosphocreatine / Q000378:metabolism*; D010761:Phosphorus Radioisotopes; D013788:Thalamus / Q000378:metabolism / Q000473:pathology
D010761:Phosphorus Radioisotopes; D010725:Phosphocreatine; D000255:Adenosine Triphosphate