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Quantitative MR spectroscopy reveals metabolic changes in the dorsolateral prefrontal cortex of patients with temporal lobe epilepsy

  • Magnetic Resonance
  • Published:
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Abstract

Objective

To characterize possible metabolic changes of the dorsolateral prefrontal cortex (DLPFC) in patients with temporal lobe epilepsy (TLE).

Methods

Quantitative proton magnetic resonance spectroscopy (1H-MRS) studies were performed on 24 TLE patients and 22 healthy controls. Metabolite concentrations were calculated using a linear combination model (LCModel) and corrected for cerebrospinal fluid contamination. Comparisons were performed between the TLE patients and the controls and between the left DLPFC and right DLPFC in each group. Pearson correlation coefficients were calculated between the metabolite concentrations and epilepsy duration and between the metabolite concentrations and voxel tissue composition: [gray matter (GM)/(GM+white matter (WM))].

Results

Metabolic asymmetry was found in controls between the left and right DLPFC, i.e., the NAA concentration of the left DLPFC was significantly higher than that of the right. However, such metabolic asymmetry was not observed in TLE patients. Compared with the controls, TLE patients showed significantly decreased NAA and Ins, and the reductions were greater in the left DLPFC. No significant correlation was found between the metabolite concentrations and epilepsy duration or between the metabolite concentrations and voxel tissue composition [GM/(GM+WM)].

Conclusions

This study suggests that TLE can produce metabolic changes to DLPFC that is remote from the seizure focus.

Key Points

• Magnetic resonance spectroscopy probes the brain metabolism noninvasively.

• Dorsolateral prefrontal reductions in NAA (a neuronal marker) and Ins are observed in TLE.

• Temporal lobe epilepsy can result in metabolic changes remote from the seizure focus.

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Abbreviations

1H-MRS:

Proton magnetic resonance spectroscopy

ANOVA:

One-way analysis of variance

ANTs:

Advanced normalization tools

CHESS:

Chemical shift selective

Cho:

Choline, including glycerophosphocholine and phosphocholine

contra:

Contralateral to the epileptic focus

Cr:

Creatine + phosphocreatine

CSF:

Cerebrospinal fluid

DLPFC:

Dorsolateral prefrontal cortex

GM:

Gray matter

Glx:

Glutamate + glutamine

Ins:

Myoinositol

ipsi:

Ipsilateral to the epileptic focus

L+R:

Average value of the left and right DLPFCs

L_sub_TLE:

Left TLE subgroup

L:

Left

LCModel:

Linear combination model

LSD:

Least significant difference

MPRAGE:

Magnetization prepared rapid gradient echo

NAA:

N-acetyl aspartate

PRESS:

Point-resolved spectroscopy

R_sub_TLE:

Right TLE subgroup

R:

Right

TLE:

Temporal lobe epilepsy

VOIs:

Volumes of interest

WM:

White matter

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Acknowledgements

We acknowledge Dr. Richard A.E. Edden for his assistance during the revision of the manuscript.

Funding

This study was funded by National Science Foundation of China (grant nos. 81371528 and 8130118) and the Sichuan Provincial Foundation of Since and Technology (grant no. 2013SZ0047).

Author information

Author notes

  1. Qiaoyue Tan and Huaiqiang Sun contributed equally to this work.

Authors and Affiliations

  1. Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, People’s Republic of China

    Qiaoyue Tan, Huaiqiang Sun, Weina Wang, Xiaorui Su, Simin Zhang & Qiyong Gong

  2. Division of Radiation Physics, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital of Sichuan University, Chengdu, People’s Republic of China

    Qiaoyue Tan

  3. Research Core Facilities, West China Hospital of Sichuan University, Chengdu, People’s Republic of China

    Huaiqiang Sun

  4. Department of Neurology, West China Hospital of Sichuan University, Chengdu, People’s Republic of China

    Xintong Wu & Nanya Hao

  5. Department of Radiology, West China Hospital of Sichuan University, No. 37 Guo Xue Xiang, Chengdu, 610041, Sichuan, People’s Republic of China

    Xibiao Yang, Jingkai Su & Qiang Yue

Authors
  1. Qiaoyue Tan
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  2. Huaiqiang Sun
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  6. Xiaorui Su
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  8. Simin Zhang
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  10. Qiang Yue
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Corresponding author

Correspondence to Qiang Yue.

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Guarantor

The scientific guarantor of this publication is Dr. Yue.

Conflict of interest

The authors of this manuscript declare no relationships with any companies.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Ethical approval

Institutional Review Board approval was obtained.

Informed consent

Written informed consent was obtained from all patients in this study.

Methodology

• prospective

• cross-sectional study

• performed at one institution

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Tan, Q., Sun, H., Wang, W. et al. Quantitative MR spectroscopy reveals metabolic changes in the dorsolateral prefrontal cortex of patients with temporal lobe epilepsy. Eur Radiol 28, 4496–4503 (2018). https://doi.org/10.1007/s00330-018-5443-x

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  • DOI: https://doi.org/10.1007/s00330-018-5443-x

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