Metabolic characteristics of cortical malformations causing epilepsy

Mueller, Susanne; Laxer, Kenneth D.; Barakos, Jerome; Cashdollar, Nathan; Flenniken, Derek; Vermathen, Peter; Matson, Gerald B.; Weiner, Michael W.

doi:10.1007/s00415-005-0819-7

Cited by 32 publications

(31 citation statements)

References 27 publications

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“…In 11 of these articles, the metabolite ratios obtained in the lesion were compared with those in a control group, and in 9 articles, the NACS was also studied. 9,19,20,[24][25][26][27]29 The abnormality most frequently found in MCD was decreased NAA or NAA/Cr in the lesion compared with a that in the control group, 9,20,[22][23][24]27,28,31 in agreement with our results, but some articles reported cases presenting a normal NAA peak in MCD compared with that in a control group. 21,29,30 This observation might be explained by the fact that these authors used single-voxel MR spectroscopy with a larger voxel volume size (3-8 cm 3 ) than the one used in our study (2.25 cm 3 ).…”

Section: Controls Patientssupporting

confidence: 91%

“…5 Previous published studies about MR spectroscopy and MCD are very different in the number of cases and methodologies used. 9,[19][20][21][22][23][24][25][26][27][28][29][30][31] Of these studies, 8 used single-voxel MR spectroscopy and 6 used multivoxel MR spectroscopy. Six are case reports, and in the remaining 8 articles, the number of patients studied varied from 8 to 31.…”

Section: Controls Patientsmentioning

confidence: 99%

“…This larger voxel may be influenced more intensely by partial volume averaging, and that could potentially affect the sensitivity of the method to subtle abnormalities. Mueller et al, 31 by using spectroscopic imaging, showed that it is possible to identify metabolically abnormal clusters interspaced in metabolically normal regions in some cases of cortical malformations.…”

Section: Controls Patientsmentioning

confidence: 99%

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Multivoxel Proton MR Spectroscopy in Malformations of Cortical Development

Leite¹,

Lucato²,

Sato³

et al. 2007

American Journal of Neuroradiology

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BACKGROUND AND PURPOSE:Malformations of cortical development (MCD) are traditionally considered as a cause of epilepsy. Our aim was to study patients with focal MCD, by using multivoxel proton MR spectroscopy; we focused not only on the lesion but also on the normal-appearing contralateral side (NACS). Our hypothesis was that the metabolic abnormality extends to the NACS; therefore, it would be inadequate to consider NACS as an internal control.

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Section: Controls Patientssupporting

confidence: 91%

Section: Controls Patientsmentioning

confidence: 99%

Section: Controls Patientsmentioning

confidence: 99%

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Multivoxel Proton MR Spectroscopy in Malformations of Cortical Development

Leite¹,

Lucato²,

Sato³

et al. 2007

American Journal of Neuroradiology

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“…Cortical malformations are not only characterized by a disturbed tissue architecture but also by an intrinsic epileptogenicity and those NAA and Cho abnormalities probably reflect both disturbances. (38) …”

Section: Identification Of the Epileptogenic Focusmentioning

confidence: 99%

N-Acetylaspartate as a Marker of Neuronal Injury in Neurodegenerative Disease

Schuff¹,

Meyerhoff²,

Mueller³

et al.

Advances in Experimental Medicine and Biology

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Considerable evidence suggests that normal aging is associated with gradual impairment of memory functioning [1]. The medial temporal lobe, especially the hippocampus, plays a central role in declarative memory processing [2]. However, magnetic resonance imaging (MRI) studies have produced controversial results concerning the age-related hippocampal volume loss, which could be due in part to the non-specificity of volume shrinkage as an indicator for neuron loss. In contrast to volume, NAA is generally considered a marker for viable neurons, because NAA reaches detectable concentrations only in neuronal tissue but not in other brain tissues, including glial cells. Using proton magnetic resonance spectroscopic imaging ( 1 H MRSI) and MRI together, we studied hippocampal metabolites and volumes in 24 healthy adults from 36 to 85 years of age. Our goals were to test whether NAA levels vary in the hippocampus as a function of normal aging and 2) to determine the relationship between hippocampal NAA and volume changes. We found NAA/Cho ratios decreased by 24% (r = −0.53, p = 0.01) and NAA/Cr ratios decreased by 26% (r = −0.61, p < 0.005) over the age range studied, while Cho/Cr remained stable, implying diminished NAA levels. In the same population, hippocampal volume shrank by 20% (r = −0.64, p < 0.05). The relationships of these measures with aging are depicted in Figure 1. Since NAA is considered a marker of neurons, these results provide stronger support for neuron loss in the aging hippocampus than volume measurements by MRI alone.Since contributions to the NAA signal may arise from both gray and white matter tissue, it is critical to differentiate between metabolite changes of gray and white matter, and other tissue types. One approach for differentiation is the use of linear regressions to predict the relationship between metabolite intensity changes and gray/white matter variations in MRSI voxels (4,(8)(9)(10)(11)(12). However, most previous MRSI studies that used linear regression averaged metabolite concentrations over different lobes of the brain, ignoring regional variations. In addition, tissues other than gray and white matter were ignored or not determined, such as white matter lesions, which occur frequently in the aged brain. We developed an approach for obtaining metabolite concentrations of gray, white matter, as well as of white matter lesions in different lobes of the brain using linear regression. We applied the new technique to measure NAA concentrations in the frontal and the parietal lobe in 40 normal elderly subjects (56 to 89 years, mean age 74 ± 8, 22 female, 18 male). NAA was about 15% lower in cortical gray matter and 23% lower in white matter lesions when compared to normal white matter. Cr was 11% higher in cortical gray than in white matter, and also about 15% higher in the parietal cortex compared to the frontal cortex. Cho was 28% lower in cortical gray matter than in white matter. Furthermore, NAA and Cr changes correlated with age. The results suggest that in addition to the hippo...

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“…Mueller et al found that metabolic abnormalities in the perilesional zone share the characteristics of MCD and that these abnormalities may be related to areas of microscopic malformations and/or intrinsic epileptogenicity. 12 In addition, MCD are metabolically heterogeneous because they may contain abnormal as well as normal areas. Abnormal diffusion anisotropy has also been found beyond the visualized limits of MCD.…”

mentioning

confidence: 99%

Spectroscopy Evidence of Diffuse Brain Abnormalities in Patients with Epileptogenic Foci

Castillo¹

2007

American Journal of Neuroradiology

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Metabolic characteristics of cortical malformations causing epilepsy

Cited by 32 publications

References 27 publications

Multivoxel Proton MR Spectroscopy in Malformations of Cortical Development

Multivoxel Proton MR Spectroscopy in Malformations of Cortical Development

N-Acetylaspartate as a Marker of Neuronal Injury in Neurodegenerative Disease

Spectroscopy Evidence of Diffuse Brain Abnormalities in Patients with Epileptogenic Foci

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