Non-invasive detection of hippocampal sclerosis: correlation between metabolite alterations detected by 1H-MRS and neuropathology
✍ Scribed by Thilo Hammen; Michelle Hildebrandt; Andreas Stadlbauer; Marc Doelken; Tobias Engelhorn; Frank Kerling; Burkhard Kasper; Johann Romstoeck; Oliver Ganslandt; Christopher Nimsky; Ingmar Blumcke; Arndt Doerfler; Hermann Stefan
- Book ID
- 102544716
- Publisher
- John Wiley and Sons
- Year
- 2008
- Tongue
- English
- Weight
- 310 KB
- Volume
- 21
- Category
- Article
- ISSN
- 0952-3480
- DOI
- 10.1002/nbm.1222
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✦ Synopsis
Abstract
We assessed ^1^H‐MRS as a screening tool for detection of hippocampal sclerosis in patients with temporal lobe epilepsy (TLE). ^1^H‐MRS was carried out in the hippocampus of 23 patients with unilateral TLE. Metabolite alterations detected by ^1^H‐MRS correlated with degree of segmental neuronal cell loss and amount of astrogliosis. Positive correlation was found between total N‐Acetylaspartate (tNAA) reduction and neuronal density in hippocampal CA1 (P < 0.001), CA3 (P = 0.015), and CA4 subfields (P = 0.031) and the dentate gyrus (P = 0.006). Neuronal cell loss in CA1 turned out to be the most predictive and only significant variable for tNAA reduction (P = 0.027). The association between myo‐inositol (m‐Ins) and astroglial glial fibrillary acidic protein (GFAP) expression revealed significantly increased m‐Ins concentrations associated with diffuse astrogliosis (m‐Ins = 6.4 ± 1.1 institutional units) compared with gliosis restricted to isolated sectors of the hippocampus (i.e. hilus) (m‐Ins = 5.2 ± 1.2 institutional units) (P = 0.039). A negative correlation was found between m‐Ins and neuronal loss in the CA4 subfield of the hippocampus (P = 0.028). Our results support ^1^H‐MRS as a suitable non‐invasive method for preoperative identification of hippocampal sclerosis in patients with TLE. The extent of tNAA reduction correlates with hippocampal neuronal cell density. Furthermore, m‐Ins is associated with the extent of hippocampal astrogliosis. Copyright © 2007 John Wiley & Sons, Ltd.