title: Magnetic resonance spectroscopy of the thalamus in patients with mesial temporal lobe epilepsy and hippocampal sclerosis.
abstract: OBJECTIVE
  to investigate potential neuronal dysfunction within the thalamus in patients suffering from mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE/HS).
  
  
  METHODS
  we examined twenty epileptic patients suffering from mesial temporal lobe epilepsy with hippocampal sclerosis (17 females, 3 males) and twenty sex- and age-matched healthy controls. H MR spectroscopic imaging (SI) was performed over the right and left thalamus in all patients and controls. In addition both hippocampi were investigated by the H MR spectroscopic single voxel (SV) technique in both groups.
  
  
  RESULTS
  statistical analysis of compared data in both groups demonstrated that the total thalamic NAA level was significantly decreased in patients with MTLE/HS as compared to healthy controls. Detailed analysis revealed a statistically significant reduction of NAA, NAA/Cr and NAA/(Cr+Cho) ratios in the thalamus ipsilateral to hippocampus affected with hippocampal sclerosis in patients compared to controls, while no significant changes were observed in the thalamus contralateral to sclerotic hippocampus. A comparison of values in ipsilateral and contralateral thalami in patients showed statistically significant difference with lower values of NAA and both ratios in the ipsilateral thalamus. Previously reported reduced hippocampal concentration of NAA, NAA/Cr and NAA/(Cr+Cho) ratios on the side of hippocampal sclerosis compared with contralateral hippocampus in patients and both hippocampi in controls was confirmed.
  
  
  CONCLUSIONS
  the present MRS data clearly indicate neuronal dysfunction within the thalamus ipsilateral to the sclerotic hippocampus of patients with mesial temporal lobe epilepsy. In agreement with other recent functional and structural neuroimagings our results confirm the role of the ipsilateral thalamus in the medial temporal/limbic epileptic network.
authors.affiliation: Brno Epilepsy Centre, Department of Neurology, Masaryk University, St. Anne's University Hospital, Brno, Czech Republic. dagmar.fojtikova@centrum.cz
authors.forename: Dagmar
authors.initials: D
authors.lastname: Fojtiková
authors.forename: Milan
authors.initials: M
authors.lastname: Brázdil
authors.forename: Antonín
authors.initials: A
authors.lastname: Skoch
authors.forename: Filip
authors.initials: F
authors.lastname: Jírů
authors.forename: Jaroslav
authors.initials: J
authors.lastname: Horký
authors.forename: Radek
authors.initials: R
authors.lastname: Marecek
authors.forename: Michal
authors.initials: M
authors.lastname: Mikl
authors.forename: Petr
authors.initials: P
authors.lastname: Krupa
mesh_terms: D000328:Adult; D004569:Electroencephalography; D004833:Epilepsy, Temporal Lobe / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology*; D005260:Female; D006624:Hippocampus / Q000473:pathology / Q000503:physiopathology*; D006801:Humans; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D012598:Sclerosis / Q000150:complications / Q000473:pathology; D012720:Severity of Illness Index; D013788:Thalamus / Q000503:physiopathology*