title: Magnetic resonance spectroscopic imaging detects abnormalities in normal-appearing frontal lobe of patients with Sturge-Weber syndrome.
abstract: BACKGROUND
  In Sturge-Weber syndrome (SWS), structural MRI abnormalities are most common in the posterior brain regions. Frontal lobe involvement increases the risk of motor impairment. The goal of this study was to determine whether Magnetic Resonance Spectroscopic Imaging (MRSI) can improve detection of frontal lobe involvement in children with SWS.
  
  
  METHODS
  Sixteen children (age: .9-10.4 years) with unilateral SWS underwent MRI with MRSI prospectively. N-acetyl-aspartate (NAA) and choline asymmetries in the posterior and frontal regions were measured.
  
  
  RESULTS
  Eight children presented normal-appearing frontal lobes on conventional MRI, but 7 of them showed abnormal NAA and/or choline content in the frontal lobe of the affected hemisphere. Lower frontal lobe gray matter NAA was associated with earlier onset of seizures (r= .76; P= .04) and impaired motor function (r=-.89, P < .001). Frontal NAA asymmetry was an independent predictor of motor function in a regression analysis (P= .01)
  
  
  CONCLUSIONS
  MRSI is more sensitive than conventional structural MRI for detection of frontal lobe involvement in SWS. Decreased frontal lobe NAA is an excellent predictor of motor functions. Thus, MRSI can provide complementary information for the assessment of normal-appearing brain regions, and may assist prognosis evaluation in children with SWS.
authors.affiliation: Department of Pediatrics, Radiology, Wayne State University, Detroit, Michigan, USA.
authors.forename: Carlos E A
authors.initials: CE
authors.lastname: Batista
authors.forename: Harry T
authors.initials: HT
authors.lastname: Chugani
authors.forename: Jiani
authors.initials: J
authors.lastname: Hu
authors.forename: E Mark
authors.initials: EM
authors.lastname: Haacke
authors.forename: Michael E
authors.initials: ME
authors.lastname: Behen
authors.forename: Emily J
authors.initials: EJ
authors.lastname: Helder
authors.forename: Csaba
authors.initials: C
authors.lastname: Juhász
mesh_terms: D001224:Aspartic Acid / Q000031:analogs & derivatives / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D002794:Choline / Q000378:metabolism; D003287:Contrast Media; D005260:Female; D005625:Frontal Lobe / Q000378:metabolism / Q000473:pathology*; D006801:Humans; D007223:Infant; D009682:Magnetic Resonance Spectroscopy / Q000379:methods*; D008297:Male; D009483:Neuropsychological Tests; D011446:Prospective Studies; D012044:Regression Analysis; D013341:Sturge-Weber Syndrome / Q000378:metabolism / Q000473:pathology*
chemical_list: D003287:Contrast Media; D001224:Aspartic Acid; C000179:N-acetylaspartate; D002794:Choline