title: Proton magnetic resonance spectroscopy in focal cortical dysplasia at 3T.
abstract: OBJECTIVE
  Focal cortical dysplasia (FCD) type II is a frequent cause of medically intractable epilepsy. On conventional MRI diagnosis may be difficult. The purpose of our study was to assess the metabolic characteristics of MRI-typical or neuropathologically confirmed FCD II lesions at 3T.
  
  
  METHODS
  In a prospective study, 13 patients with drug-resistant epilepsy and MRI diagnosis of FCD II (seven neuropathologically confirmed) were investigated by single-volume proton magnetic resonance spectroscopy ((1)H MRS). We performed an intra-individual comparison placing spectroscopic volumes of interest in the lesion and in the apparently normal contralateral hemisphere. Spectroscopic results were correlated with clinical data.
  
  
  RESULTS
  Matched pair analysis revealed a significant increase in absolute choline (Cho) concentration in the lesion volume (+32%, p=0.015) compared to the control volume. This increase was associated with a significant decrease in N-acetyl-aspartate (NAA) concentration (-13%; p=0.008). Mean myo-inositol (Ins) levels were distinctly (+36%) but not significantly (p=0.051) elevated. Lesional creatine (Cr) concentration correlated significantly with the frequency of seizures (Spearman-Rho r=0.898; p=0.002), while concentrations of NAA, Cho and Ins did not correlate with clinical or imaging parameters.
  
  
  CONCLUSIONS
  MR spectroscopy revealed a characteristic metabolic pattern in FCD II lesions that helps to distinguish normal from epileptogenic tissue.
authors.affiliation: Department of Radiology, University of Bonn, Germany. Electronic address: Henriette.Tschampa@ukb.uni-bonn.de.
authors.forename: Henriette J
authors.initials: HJ
authors.lastname: Tschampa
authors.affiliation: Department of Radiology, University of Bonn, Germany; Department of Neuroradiology, University Medical Center Freiburg, Germany.
authors.forename: Horst
authors.initials: H
authors.lastname: Urbach
authors.affiliation: Department of Radiology, University of Bonn, Germany.
authors.forename: Frank
authors.initials: F
authors.lastname: Träber
authors.affiliation: Department of Radiology, University of Bonn, Germany.
authors.forename: Alois M
authors.initials: AM
authors.lastname: Sprinkart
authors.affiliation: Department of Radiology, University of Bonn, Germany.
authors.forename: Susanne
authors.initials: S
authors.lastname: Greschus
authors.affiliation: Department of Neurology, University of Cologne, Germany.
authors.forename: Michael P
authors.initials: MP
authors.lastname: Malter
authors.affiliation: Department of Epileptology, University of Bonn, Germany.
authors.forename: Rainer
authors.initials: R
authors.lastname: Surges
authors.affiliation: Department of Radiology, University of Bonn, Germany; Philips Healthcare, Hamburg, Germany.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Gieseke
authors.affiliation: Department of Radiology, University of Bonn, Germany.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Block
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001224:Aspartic Acid / Q000031:analogs & derivatives / Q000378:metabolism; D001921:Brain / Q000378:metabolism* / Q000473:pathology; D002675:Child, Preschool; D002794:Choline / Q000378:metabolism; D003401:Creatine / Q000378:metabolism; D000069279:Drug Resistant Epilepsy / Q000175:diagnosis / Q000378:metabolism* / Q000473:pathology; D004827:Epilepsy / Q000175:diagnosis / Q000378:metabolism* / Q000473:pathology; D005260:Female; D006801:Humans; D007223:Infant; D007294:Inositol / Q000378:metabolism; D008297:Male; D065703:Malformations of Cortical Development, Group I / Q000175:diagnosis / Q000378:metabolism* / Q000473:pathology; D008875:Middle Aged; D011446:Prospective Studies; D066244:Proton Magnetic Resonance Spectroscopy / Q000295:instrumentation* / Q000379:methods*; D055815:Young Adult
chemical_list: D001224:Aspartic Acid; D007294:Inositol; C000179:N-acetylaspartate; D003401:Creatine; D002794:Choline
keywords: (1)H magnetic resonance spectroscopy; Brain metabolism; Epilepsy; Focal cortical dysplasia; Malformation of cortical development