Proton MRS may predict AED response in patients with TLE

Summary Purpose:  To compare relative N‐acetylaspartate (NAA) measurements in temporal lobe epilepsy (TLE) patients with good response to the first trial of antiepileptic drugs (AEDs) (an important prognostic factor) to TLE patients who failed the first AED monotherapy and required further AED trial...

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Bibliographic Details
Published in:Epilepsia (Copenhagen) 2010-05, Vol.51 (5), p.783-788
Main Authors: Campos, Bruno A. G., Yasuda, Clarissa L., Castellano, Gabriela, Bilevicius, Elizabeth, Li, Li M., Cendes, Fernando
Format: Article
Language:English
Subjects:
1H‐MRS
Adult
Anticonvulsants - pharmacology
Anticonvulsants - therapeutic use
Antiepileptic drugs
Aspartic Acid - analogs & derivatives
Aspartic Acid - metabolism
Biological and medical sciences
Drug Resistance
Drug Therapy, Combination
Electroencephalography
Epilepsy, Temporal Lobe - diagnosis
Epilepsy, Temporal Lobe - drug therapy
Female
Functional Laterality - drug effects
Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy
Hippocampus - drug effects
Hippocampus - metabolism
Humans
Magnetic Resonance Imaging
Magnetic Resonance Spectroscopy - statistics & numerical data
Male
Medical sciences
Nervous system (semeiology, syndromes)
Neurology
Prognosis
Seizures
Temporal Lobe - drug effects
Temporal Lobe - metabolism
Temporal lobe epilepsy
Treatment Outcome
Vascular diseases and vascular malformations of the nervous system
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Summary:Summary Purpose:  To compare relative N‐acetylaspartate (NAA) measurements in temporal lobe epilepsy (TLE) patients with good response to the first trial of antiepileptic drugs (AEDs) (an important prognostic factor) to TLE patients who failed the first AED monotherapy and required further AED trials with monotherapy or polytherapy. Methods:  We studied 25 consecutive TLE patients who responded to first AED (responders) and 21 who did not (failure‐group), as well as 27 controls. Patients were seen regularly in our Epilepsy Service and underwent electroencephalography (EEG) investigation, high‐resolution magnetic resonance imaging (MRI), and single‐voxel proton MR spectroscopy. Voxels were tailored to the medial temporal region on each side and involved the anterior hippocampus. Results:  Analysis of variance (ANOVA) demonstrated significant variation of NAA/creatine (NAA/Cr) values in both hippocampi, ipsilateral and contralateral to the EEG focus (p 
ISSN:0013-9580
1528-1167
DOI:10.1111/j.1528-1167.2009.02379.x