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1H-MRS imaging in intractable frontal lobe epilepsies characterized by depth electrode recording

2005; Elsevier BV; Volume: 26; Issue: 4 Linguagem: Inglês

10.1016/j.neuroimage.2005.03.023

1095-9572

Maxime Guye, Jean‐Philippe Ranjeva, Yann Le Fur, Fabricē Bartolomei, Sylviane Confort‐Gouny, Jean Régis, Patrick Chauvel, Patrick J. Cozzone,

Functional Brain Connectivity Studies

Presurgical evaluation of frontal lobe epilepsy (FLE) remains a challenging issue and frequently requires invasive depth electrode recording. In this study, we aimed at evaluating the potential usefulness of a non-invasive technique such as proton magnetic resonance spectroscopic imaging (1H-MRSI) in the presurgical evaluation of FLE and at investigating the potential electrophysiological correlates of the metabolic disturbances as defined by 1H-MRSI. We compared the distribution of 1H-MRSI abnormalities with the electrophysiological abnormalities defined by stereo-electroencephalography (SEEG) recording in 12 patients presenting with several subtypes of FLE. We also used 12 control subjects in order to obtain normative 1H-MRSI data. We used a multilevel 1H-MRSI protocol to better sample the principal regions of the frontal lobe. We also applied a metabolic mapping technique allowing a visual display of metabolic data. A significant decrease of both N-acetyl-aspartate/phosphocreatine-creatine and N-acetyl-aspartate/(choline-compounds + phosphocreatine-creatine) ratios was observed in regions involved in the epileptogenic zone (EZ) and/or the irritative zone (IZ) compared to regions without electrical abnormalities in the same patients (P = 0.044 and P = 0.018, respectively), and also compared to controls (P = 0.004 and P = 0.0001, respectively). No significant differences in metabolic ratios were observed between those regions involved in the EZ and those involved in the IZ only. Our results suggest a link between the relative decrease of N-acetyl-aspartate and the EZ as well as the IZ in FLE. Thus, multilevel 1H-MRSI protocol may add pertinent information during the non-invasive presurgical evaluation of FLE.