Proton spectroscopy of the thalamus in a homogeneous sample of patients with easy-to-control juvenile myoclonic epilepsy

Abstract

ObjectiveJuvenile myoclonic epilepsy (JME) is a subtype of genetically determined generalized epilepsy that does not present abnormalities on conventional magnetic resonance imaging. The aim of this study was to identify metabolic alterations in the thalamus in a clinically homogeneous sample of patients with easy-to-control JME, using short-echo time proton magnetic resonance spectroscopy (MRS).Materials and MethodsWe performed single-voxel (2 cm × 2 cm × 2 cm), short-echo time (TE = 35 ms) proton MRS of the thalamus in 21 patients with JME and in 14 healthy age-matched controls. We quantified N-acetylaspartate (NAA), total NAA, creatine (Cr), choline, and myo-inositol (MI), as well as the sum of glutamate and glutamine signals, all scaled to internal water content, and we calculated metabolite ratios using Cr as a reference. Values of p < 0.05 were considered significant.ResultsThe MI level and the MI/Cr ratio were significantly lower in the thalami of patients diagnosed with JME than in those of the controls. Other metabolites and their ratios did not differ significantly between the two groups.ConclusionIn our sample of 21 JME patients, we identified lower levels of MI in the thalamus. No significant abnormalities were observed in the concentrations or ratios of other metabolites.

Altered plasma glutamate and glutamine levels in patients with drug-resistant and drug-responsive symptomatic focal epilepsy

“…28 However, cerebral glutamate concentrations were not changed after treatment with VPA, TPM or LEV in previous longitudinal studies. [28][29][30] In the current study, the median plasma glutamate level was higher in the DRE patients than in the controls. This difference was probably not due to the effect of AEDs in our study, because the AEDs used in our study would most likely reduce the extracellular glutamate levels.…”

Investigation of Patients With Eye Closure Sensitive Epilepsy With Magnetic Resonance Spectroscopy

“…16,17,[20][21][22][23][24] Such studies included mostly patients with partial and particularly temporal lobe epilepsy, while there have been only a limited number of studies involving GGE cases. [25][26][27][28] The first study to report proton spectral changes in epilepsy patients was published by Matthews et al, 29 in which increased lactate signals, and mainly decreased NAA peaks were identified in patients with focal epilepsy. The presence of NAA in the brain is believed to represent cellular integrity, and it is thus considered that a decrease in NAA or NAA/Cr levels is an indication of neuronal and/or axonal loss, loss, and dysfunction of viable neurons.…”

“…16,17,20–24 Such studies included mostly patients with partial and particularly temporal lobe epilepsy, while there have been only a limited number of studies involving GGE cases. 25–28…”