title: 1H MRSI and social communication deficits in pediatric complex partial seizures.
abstract: OBJECTIVE
  To investigate relationships between regional brain metabolites, social communication deficits, and seizure frequency in children and adolescents with cryptogenic epilepsy with complex partial seizures (CPS).
  
  
  METHODS
  In 12 children and adolescents with CPS and 23 age- and gender-matched healthy controls, we acquired proton magnetic resonance spectroscopic imaging (MRSI) at 1.5 T and 30 ms echo-time from bilateral inferior frontal and superior temporal gyri, regions associated with social communication deficits. Videotaped speech samples of all the subjects were coded for social communication deficits and parents provided information on seizure frequency.
  
  
  RESULTS
  Four MRSI findings emerged in right inferior frontal gyrus. N-acetyl-aspartate (NAA) plus N-acetyl-aspartyl-glutamate (NAAG)--together called "tNAA"--was 11.4% lower in patients with CPS than in controls. Choline-compounds (Cho) were 15.4% lower in CPS than in controls. Within CPS, higher tNAA was associated with more frequent seizures and abnormal social communication.
  
  
  CONCLUSIONS
  Localization of findings to right inferior frontal cortex supports the involvement of this area in social communication deficits and may be related to atypical lateralization of expressive language in pediatric epilepsy. Lower levels of tNAA and Cho may indicate local neuronal or glial damage or underpopulation due to excitotoxicity or other causes. The sensitivity of tNAA to seizure frequency suggests effects of ongoing CPS on neuronal and glial function in this brain region.
authors.affiliation: Division of Child and Adolescent Psychiatry, UCLA Semel Institute for Neurosciences, Los Angeles, California 90024-1759, USA. joneill@mednet.ucla.edu
authors.forename: Joseph
authors.initials: J
authors.lastname: O'Neill
authors.forename: Ronald
authors.initials: R
authors.lastname: Seese
authors.forename: Matthew
authors.initials: M
authors.lastname: Hudkins
authors.forename: Prabha
authors.initials: P
authors.lastname: Siddarth
authors.forename: Jennifer
authors.initials: J
authors.lastname: Levitt
authors.forename: Pengju Benjamin
authors.initials: PB
authors.lastname: Tseng
authors.forename: Keng Nei
authors.initials: KN
authors.lastname: Wu
authors.forename: Suresh
authors.initials: S
authors.lastname: Gurbani
authors.forename: W Donald
authors.initials: WD
authors.lastname: Shields
authors.forename: Rochelle
authors.initials: R
authors.lastname: Caplan
mesh_terms: D000293:Adolescent; D001224:Aspartic Acid / Q000031:analogs & derivatives; D016022:Case-Control Studies; D002540:Cerebral Cortex / Q000378:metabolism* / Q000473:pathology; D002648:Child; D002794:Choline; D003147:Communication Disorders / Q000175:diagnosis* / Q000209:etiology*; D003401:Creatine; D017029:Epilepsy, Complex Partial / Q000150:complications*; D005260:Female; D007839:Functional Laterality; D006801:Humans; D008279:Magnetic Resonance Imaging; D009682:Magnetic Resonance Spectroscopy / Q000379:methods; D008297:Male; D011522:Protons; D012920:Social Behavior Disorders / Q000150:complications* / Q000175:diagnosis*
chemical_list: D011522:Protons; D001224:Aspartic Acid; C000179:N-acetylaspartate; D003401:Creatine; D002794:Choline