title: Oxygen-enhanced MRI in temporal lobe epilepsy: diagnosis and lateralization.
abstract: We explored the diagnostic value of oxygen-enhanced MRI, a novel technique for measuring regional brain metabolism, in a set of normal adult volunteers and temporal lobe epilepsy patients. Eight right-handed adult normal volunteers and ten right-handed patients with temporal lobe epilepsy were studied. Six patients had lesions concordant with their epilepsy on high-resolution (3T) structural MRI. Four patients were nonlesional. Hyperoxia (oxygen enhancement, OE) was carried out by administering 100% O(2) in epochs by mask or cannula interleaved with breathing of normal atmospheric air. The T2* (blood oxygen level dependent, BOLD) signal was recorded in continuously acquired echo-planar images. Data from nine temporal lobe subregions were subjected to spectral analysis and statistical testing. OE resulted in unambiguous concordant positive T2* signal change in all subjects. Analysis of the distribution of spectral power within the temporal lobe revealed a significant (p<0.025, one-sided) group difference between normals and epilepsy patients, with seven patients exhibiting large deviations from normalcy that lateralized their disease. Two such patients had nonlesional MRIs. Oxygen-enhanced MRI is a promising metabolic imaging modality for the diagnosis and lateralization of oxidative metabolic derangement associated with lesional and nonlesional temporal lobe epilepsy.
authors.affiliation: Department of Neurology, University of Texas Health Science Center, Houston, TX 77030, USA. Giridhar.P.Kalamangalam@uth.tmc.edu
authors.forename: Giridhar P
authors.initials: GP
authors.lastname: Kalamangalam
authors.forename: Jeffrey T
authors.initials: JT
authors.lastname: Nelson
authors.forename: Timothy M
authors.initials: TM
authors.lastname: Ellmore
authors.forename: Ponnada A
authors.initials: PA
authors.lastname: Narayana
mesh_terms: D000328:Adult; D000368:Aged; D001921:Brain / Q000378:metabolism* / Q000473:pathology; D004833:Epilepsy, Temporal Lobe / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010100:Oxygen
chemical_list: D010100:Oxygen