title: Investigation of glutamine and GABA levels in patients with idiopathic generalized epilepsy using MEGAPRESS.
abstract: OBJECTIVE
  Idiopathic generalized epilepsies (IGE) comprise a group of clinical syndromes associated with spike wave discharges, putatively linked to alterations in neurotransmission. The purpose of this study was to investigate whether patients with IGE have altered glutamine and γ-aminobutyric acid (GABA) levels indicative of altered excitatory and inhibitory neurotransmission in frontal regions.
  
  
  METHODS
  Single-voxel MEGA-edited PRESS magnetic resonance imaging (MRI) spectra were acquired from a 30-mL voxel in the dorsolateral prefrontal cortex in 13 patients with IGE (8 female) and 16 controls (9 female) at 3T. Metabolite concentrations were derived using LCModel. Differences between groups were investigated using an unpaired t-test.
  
  
  RESULTS
  Patients with IGE were found to have significantly higher glutamine than controls (P = 0.02). GABA levels were also elevated in patients with IGE (P = 0.03).
  
  
  CONCLUSIONS
  Patients with IGE have increased frontal glutamine and GABA compared with controls. Since glutamine has been suggested to act as a surrogate for metabolically active glutamate, it may represent a marker for excitatory neurotransmission.
authors.affiliation: Department of Clinical Neuroscience Institute of Psychiatry, King's College London, London, UK.
authors.forename: Fahmida A
authors.initials: FA
authors.lastname: Chowdhury
authors.forename: Ruth L
authors.initials: RL
authors.lastname: O'Gorman
authors.forename: Lina
authors.initials: L
authors.lastname: Nashef
authors.forename: Robert D
authors.initials: RD
authors.lastname: Elwes
authors.forename: Richard A
authors.initials: RA
authors.lastname: Edden
authors.forename: James B
authors.initials: JB
authors.lastname: Murdoch
authors.forename: Gareth J
authors.initials: GJ
authors.lastname: Barker
authors.forename: Mark P
authors.initials: MP
authors.lastname: Richardson
mesh_terms: D000328:Adult; D004829:Epilepsy, Generalized / Q000378:metabolism*; D005260:Female; D005625:Frontal Lobe / Q000378:metabolism*; D005973:Glutamine / Q000378:metabolism*; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D009682:Magnetic Resonance Spectroscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D055815:Young Adult; D005680:gamma-Aminobutyric Acid / Q000378:metabolism*
chemical_list: D005973:Glutamine; D005680:gamma-Aminobutyric Acid
keywords: GABA; MR spectroscopy; glutamine; idiopathic generalized epilepsy