NEUROLOGY 1994;44:1411
© 1994 American Academy of Neurology
Magnetic resonance spectroscopy in temporal lobe epilepsy
A. Connelly, PhD,
G. D. Jackson, FRACP,
J. S. Duncan, DM,
M. D. King, PhD and
D. G. Gadian, DPhil
Radiology and Physics Unit (Drs. Connelly, King, and Gadian) and the Neurosciences Unit (Dr. Jackson), Institute of Child Health, and the Epilepsy Research Group (Dr. Duncan), Institute of Neurology, Queen Square, London, UK.
We used proton magnetic resonance spectroscopy (1H MRS) to investigate the temporal lobes of 25 patients with temporal lobe epilepsy. Spectra were obtained from 2 x 2 x 2 cm cubes in the medial region of the temporal lobe, and were analyzed on the basis of signals from N-acetylaspartate (NAA), creatine + phosphocreatine (Cr), and choline-containing compounds (Cho). In comparison with control subjects, the temporal lobes ipsilateral to the seizure focus showed a mean reduction of 22% in the NAA signal, with a 15% increase in the Cr signal and a 25% increase in the Cho signal. There were smaller effects in the contralateral temporal lobes. These spectral abnormalities may reflect neuronal loss or damage, together with reactive astrocytosis. The NAA/Cho+Cr ratio was abnormally low in 88% of the patients, 40% showing bilateral effects. On the basis of the NAA/Cho+Cr ratio, we correctly achieved lateralization in 15 cases, with three incorrect. Two of the incorrect lateralizations also had imaging abnormalities on the contralateral side, and the other had severe bilateral abnormalities on MRS. We conclude that 1H MRS provides useful information in the preoperative investigation of patients with temporal lobe epilepsy, contributing to lateralization and detecting bilateral abnormalities.
Address correspondence and reprint requests to Prof. David G. Gadian, Radiology and Physics Unit, Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK.
Supported by Action Research and the Wellcome Trust.
Received September 22, 1993. Accepted in final form January 28, 1994.
This article has been cited by other articles:

|
 |

|
 |
 
H. P. Hetherington, R. I. Kuzniecky, K. Vives, O. Devinsky, S. Pacia, D. Luciano, B. Vasquez, S. Haut, D. D. Spencer, and J. W. Pan
A subcortical network of dysfunction in TLE measured by magnetic resonance spectroscopy
Neurology,
December 11, 2007;
69(24):
2256 - 2265.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
G. Lantz, M. Seeck, and F. Lazeyras
Extent of Preoperative Abnormalities and Focus Lateralization Predict Postoperative Normalization of Contralateral 1H-Magnetic Resonance Spectroscopy Metabolite Levels in Patients with Temporal Lobe Epilepsy.
AJNR Am. J. Neuroradiol.,
September 1, 2006;
27(8):
1766 - 1769.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
J. F. A. Jansen, W. H. Backes, K. Nicolay, and M. E. Kooi
1H MR Spectroscopy of the Brain: Absolute Quantification of Metabolites.
Radiology,
August 1, 2006;
240(2):
318 - 332.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
Y. W. Lui, A. O. Nusbaum, W. B. Barr, G. Johnson, J. S. Babb, D. Orbach, A. Kim, G. Laliotis, and O. Devinsky
Correlation of Apparent Diffusion Coefficient with Neuropsychological Testing in Temporal Lobe Epilepsy
AJNR Am. J. Neuroradiol.,
August 1, 2005;
26(7):
1832 - 1839.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
J. O. J. Lundbom, K. E. Vuori, E. K. Gaily, R. I. M.-L. Granstrom, G. C. Blomstedt, A.-M. Hakkinen, S. M. Heikkinen, and N. M. I. Lundbom
Metabolite Phantom Correction of the Nonuniform Volume-Selection Profiles in MR Spectroscopic Imaging: Application to Temporal Lobe Epilepsy
AJNR Am. J. Neuroradiol.,
May 1, 2005;
26(5):
1072 - 1077.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
F Zubler, M Seeck, T Landis, F Henry, and F Lazeyras
Contralateral medial temporal lobe damage in right but not left temporal lobe epilepsy: a 1H magnetic resonance spectroscopy study
J. Neurol. Neurosurg. Psychiatry,
September 1, 2003;
74(9):
1240 - 1244.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
P. Vermathen, K. D. Laxer, N. Schuff, G. B. Matson, and M. W. Weiner
Evidence of Neuronal Injury Outside the Medial Temporal Lobe in Temporal Lobe Epilepsy: N-Acetylaspartate Concentration Reductions Detected with Multisection Proton MR Spectroscopic Imaging--Initial Experience
Radiology,
January 1, 2003;
226(1):
195 - 202.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
R. C. Knowlton, B. Abou-Khalil, S. M. Sawrie, R. C. Martin, R. E. Faught, and R. I. Kuzniecky
In Vivo Hippocampal Metabolic Dysfunction in Human Temporal Lobe Epilepsy
Arch Neurol,
December 1, 2002;
59(12):
1882 - 1886.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
A. A. Capizzano, P. Vermathen, K. D. Laxer, G. B. Matson, A. A. Maudsley, B. J. Soher, N. W. Schuff, and M. W. Weiner
Multisection Proton MR Spectroscopy for Mesial Temporal Lobe Epilepsy
AJNR Am. J. Neuroradiol.,
September 1, 2002;
23(8):
1359 - 1368.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
P. Vermathen, G. Ende, K. D. Laxer, J. A. Walker, R. C. Knowlton, N. M. Barbaro, G. B. Matson, and M. W. Weiner
Temporal lobectomy for epilepsy: Recovery of the contralateral hippocampus measured by 1H MRS
Neurology,
August 27, 2002;
59(4):
633 - 636.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
K. Kantarci, C. Shin, J. W. Britton, E. L. So, G. D. Cascino, and C. R. Jack Jr.
Comparative diagnostic utility of 1H MRS and DWI in evaluation of temporal lobe epilepsy
Neurology,
June 25, 2002;
58(12):
1745 - 1753.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
S. B. Antel, L. M. Li, F. Cendes, D. L. Collins, R. E. Kearney, R. Shinghal, and D. L. Arnold
Predicting surgical outcome in temporal lobe epilepsy patients using MRI and MRSI
Neurology,
May 28, 2002;
58(10):
1505 - 1512.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
R. Kuzniecky, C. Palmer, J. Hugg, R. Martin, S. Sawrie, R. Morawetz, E. Faught, and R. Knowlton
Magnetic Resonance Spectroscopic Imaging in Temporal Lobe Epilepsy: Neuronal Dysfunction or Cell Loss?
Arch Neurol,
December 1, 2001;
58(12):
2048 - 2053.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
R. L. Wolf, D. C. Alsop, I. Levy-Reis, P. T. Meyer, J. A. Maldjian, J. Gonzalez-Atavales, J. A. French, A. Alavi, and J. A. Detre
Detection of Mesial Temporal Lobe Hypoperfusion in Patients with Temporal Lobe Epilepsy by Use of Arterial Spin Labeled Perfusion MR Imaging
AJNR Am. J. Neuroradiol.,
August 1, 2001;
22(7):
1334 - 1341.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
R.C. Scott, D.G. Gadian, J.H. Cross, S.J. Wood, B.G.R. Neville, and A. Connelly
Quantitative magnetic resonance characterization of mesial temporal sclerosis in childhood
Neurology,
June 26, 2001;
56(12):
1659 - 1665.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
M. Feichtinger, E. Pauli, I. Schafer, K. W. Eberhardt, B. Tomandl, J. Huk, and H. Stefan
Ictal Fear in Temporal Lobe Epilepsy: Surgical Outcome and Focal Hippocampal Changes Revealed by Proton Magnetic Resonance Spectroscopy Imaging
Arch Neurol,
May 1, 2001;
58(5):
771 - 777.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
S.-W. Park, K.-H. Chang, H.-D. Kim, I. C. Song, D. S. Lee, S. K. Lee, C.-K. Chung, I. K. Yu, M. H. Han, and Y. H. Park
Lateralizing Ability of Single-voxel Proton MR Spectroscopy in Hippocampal Sclerosis: Comparison with MR Imaging and Positron Emission Tomography
AJNR Am. J. Neuroradiol.,
April 1, 2001;
22(4):
625 - 631.
[Abstract]
[Full Text]
|
 |
|

|
 |

|
 |
 
Y.-Y. Hsu, M.-C. Chen, K.-E. Lim, and C. Chang
Reproducibility of Hippocampal Single-Voxel Proton MR Spectroscopy and Chemical Shift Imaging
Am. J. Roentgenol.,
February 1, 2001;
176(2):
529 - 536.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
E. Angelie, A. Bonmartin, A. Boudraa, P.-M. Gonnaud, J.-J. Mallet, and D. Sappey-Marinier
Regional Differences and Metabolic Changes in Normal Aging of the Human Brain: Proton MR Spectroscopic Imaging Study
AJNR Am. J. Neuroradiol.,
January 1, 2001;
22(1):
119 - 127.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
A. A. Capizzano, P. Vermathen, K. D. Laxer, G. R. Ende, D. Norman, H. Rowley, G. B. Matson, A. A. Maudsley, M. R. Segal, and M. W. Weiner
Temporal Lobe Epilepsy: Qualitative Reading of
Radiology,
January 1, 2001;
218(1):
144 - 151.
[Abstract]
[Full Text]
|
 |
|

|
 |

|
 |
 
C.H. Ferrier, G. Alarcon, A. Glover, M. Koutroumanidis, R.G. Morris, A. Simmons, R.D.C. Elwes, T. Cox, C.D. Binnie, and C.E. Polkey
N-Acetylaspartate and creatine levels measured by 1H MRS relate to recognition memory
Neurology,
December 26, 2000;
55(12):
1874 - 1883.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
S. P. Miller, L. M. Li, F. Cendes, E. Tasch, F. Andermann, F. Dubeau, and D. L. Arnold
Medial temporal lobe neuronal damage in temporal and extratemporal lesional epilepsy
Neurology,
April 11, 2000;
54(7):
1465 - 1470.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
D. G. Gadian, J. Aicardi, K. E. Watkins, D. A. Porter, M. Mishkin, and F. Vargha-Khadem
Developmental amnesia associated with early hypoxic-ischaemic injury
Brain,
March 1, 2000;
123(3):
499 - 507.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
P. Vermathen, K. D. Laxer, G. B. Matson, and M. W. Weiner
Hippocampal Structures: Anteroposterior N-acetylaspartate Differences in Patients with Epilepsy and Control Subjects as Shown with Proton MR Spectroscopic Imaging
Radiology,
February 1, 2000;
214(2):
403 - 410.
[Abstract]
[Full Text]
|
 |
|

|
 |

|
 |
 
R. Kuzniecky, J. Hugg, H. Hetherington, R. Martin, E. Faught, R. Morawetz, and F. Gilliam
Predictive value of 1H MRSI for outcome in temporal lobectomy
Neurology,
September 1, 1999;
53(4):
694 - 694.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
Y.-Y. Hsu, C. Chang, C.-N. Chang, N.-S. Chu, K.-E. Lim, and J.-C. Hsu
Proton MR Spectroscopy in Patients with Complex Partial Seizures: Single-Voxel Spectroscopy versus Chemical-Shift Imaging
AJNR Am. J. Neuroradiol.,
April 1, 1999;
20(4):
643 - 651.
[Abstract]
[Full Text]
|
 |
|

|
 |

|
 |
 
L. A. Mitchell, G. D. Jackson, R. M. Kalnins, M. M. Saling, G. J. Fitt, R. D. Ashpole, and S. F. Berkovic
Anterior temporal abnormality in temporal lobe epilepsy: A quantitative MRI and histopathologic study
Neurology,
January 1, 1999;
52(2):
327 - 327.
[Abstract]
[Full Text]
|
 |
|

|
 |

|
 |
 
A. Connelly, W. Van Paesschen, D. A. Porter, C. L. Johnson, J. S. Duncan, and D. G. Gadian
Proton magnetic resonance spectroscopy in MRI-negative temporal lobe epilepsy
Neurology,
July 1, 1998;
51(1):
61 - 66.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
R. Kuzniecky, J. W. Hugg, H. Hetherington, E. Butterworth, E. Bilir, E. Faught, and F. Gilliam
Relative utility of 1H spectroscopic imaging and hippocampal volumetry in the lateralization of mesial temporal lobe epilepsy
Neurology,
July 1, 1998;
51(1):
66 - 71.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
F. Vargha-Khadem, D. G. Gadian, K. E. Watkins, A. Connelly, W. Van Paesschen, and M. Mishkin
Differential Effects of Early Hippocampal Pathology on Episodic and Semantic Memory
Science,
July 18, 1997;
277(5324):
376 - 380.
[Abstract]
[Full Text]
|
 |
|

|
 |

|
 |
 
F. Vargha-Khadem, E. Isaacs, and V. Muter
A Review of Cognitive Outcome After Unilateral Lesions Sustained During Childhood
J Child Neurol,
October 1, 1994;
9(2_suppl):
2S67 - 2S73.
[Abstract]
[PDF]
|
 |
|
|