Skip to main content
SpringerLink
Log in

Effect of seizure on hippocampus in mesial temporal lobe epilepsy and neocortical epilepsy: an MRS study

  • Diagnostic Neuroradiology
  • Published:
Neuroradiology Aims and scope Submit manuscript

Abstract

This study was performed to evaluate the effect of seizures on the bilateral hippocampus in mesial temporal lobe epilepsy (mTLE) and neocortical epilepsy by single voxel proton magnetic resonance spectroscopy (MRS). Forty-one patients with mTLE having unilateral hippocampal sclerosis and 43 patients with a neocortical epilepsy who underwent subsequent epilepsy surgery were recruited. Ninety-five percent confidence intervals of N-acetyl aspartate/choline (NAA/Cho) and NAA/creatine (NAA/Cr) ratios in 20 healthy control subjects were used as threshold values to determine abnormal NAA/Cho and NAA/Cr. NAA/Cho and NAA/Cr were significantly lower in the ipsilateral hippocampus of mTLE and neocortical epilepsy. Using asymmetry indices for patients with bilaterally abnormal ratios of NAA/Cho and NAA/Cr in addition to using unilateral abnormal ratio, the seizure focus was correctly lateralized in 65.9% of patients with mTLE and 48.8% of neocortical epilepsy patients. Bilateral NAA/Cho abnormality was significantly related to a poor surgical outcome in mTLE. No significant relationship was found between the results of NAA/Cho or NAA/Cr and surgical outcome in neocortical epilepsy. The mean contralateral NAA/Cr ratio of the hippocampus in mTLE was significantly lower in patients with a history of secondary generalized tonic-clonic seizure (SGTCS) than in those without. Our results demonstrate effects of seizures on the hippocampi in neocortical epilepsy and the relation between SGTCS and NAA/Cr of the contralateral hippocampus in mTLE. This proves the presence of a seizure effect on the hippocampus in neocortical epilepsy as well as in mTLE.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Hugg JW, Laxer KD, Matson GB, Maudsley AA, Weiner MW (1993) Neuronal loss localizes human temporal lobe epilepsy by in vivo proton magnetic resonance spectroscopic imaging. Ann Neurol 34:788–794

    Article  PubMed  Google Scholar 

  2. Cendes F, Andermann F, Preul MC, Arnold DL (1994) Lateralization of temporal lobe epilepsy based on regional metabolic abnormalities in proton magnetic resonance spectroscopic images. Ann Neurol 35:211–216

    Article  PubMed  Google Scholar 

  3. Connelly A, Jackson GD, Duncan JS, King D, Gadian DG (1994) Magnetic resonance spectroscopy in temporal lobe epilepsy. Neurology 44:1411–1417

    PubMed  Google Scholar 

  4. Cendes F, Caramanos Z, Andermann F, Dubeau F, Arnold DL (1997) Proton magnetic resonance spectroscopic imaging and magnetic resonance imaging volumetry in the lateralization of temporal lobe epilepsy: a series of 100 patients. Ann Neurol 42:737–746

    Article  PubMed  Google Scholar 

  5. Urenjak J, Williams SR, Gadian DG, Noble M (1993) Proton nuclear magnetic resonance spectroscopy unambiguously identifies different neural cell types. J Neurosci 13:981–989

    PubMed  Google Scholar 

  6. Nakano M, Ueda H, Li JY, Matsumoto M, Yanagihara T (1998) Measurement of regional N-acetylaspartate after transient global ischemia in gerbils with and without ischemic tolerance: an index of neuronal survival. Ann Neurol 44:334–340

    Article  PubMed  Google Scholar 

  7. Matthews PM, Andermann F, Arnold DL (1990) A proton magnetic resonance spectroscopic study of focal epilepsy in humans. Neurology 40:985–989

    PubMed  Google Scholar 

  8. Dautry C, Vaufrey F, Brouillet E, Bizat N, Henry PG, Conde F, Bloch G, Hantraye P (2000) Early N-acetylaspartate depletion is a marker of neuronal dysfunction in rats and primates chronically treated with mitochondrial toxin 3-nitropropionic acid. J Cereb Blood Flow Metab 20:789–799

    PubMed  Google Scholar 

  9. Demougeot C, Garnier P, Mossiat C, Bertrand N, Giroud M, Beley A, Marie C (2001) N-acetylaspartate, a marker of both cellular dysfunction and neuronal loss: its relevance to studies of acute brain injury. J Neurochem 77:408–415

    Article  PubMed  Google Scholar 

  10. De Stefano N, Matthews PM, Arnold DL (1995) Reversible decrease in N-acetylaspartate after acute brain injury. Mag Reson Med 34:721–727

    Google Scholar 

  11. Hugg JW, Kuzniecky RI, Gilliam F, Morawetz RB, Faught E, Hetherington HP (1996) Normalization of contralateral metabolic function following temporal lobectomy demonstrated by H-1 magnetic resonance imaging. Ann Neurol 40:236–239

    Article  PubMed  Google Scholar 

  12. Karla S, Cashman NR, Genge A, Arnold DL (1998) Recovery of N-acetylaspartate in corticomotor neurons of patients with ALS after riluzole therapy. Neuroreport 9:1757–1761

    PubMed  Google Scholar 

  13. Vermathen P, Ende G, Laxer KD, Walker JA, Knowlton RC, Barbaro NM, Matson GB, Weiner MW (2002) Temporal lobectomy for epilepsy: recovery of the contralateral hippocampus measured by 1H MRS. Neurology 59:633–636

    PubMed  Google Scholar 

  14. Kuzniecky R, Palmer C, Hugg J, Martin R, Sawrie S, Moraetz R, Faught E, Knowlton R (2001) Magnetic resonance spectroscopic imaging in temporal lobe epilepsy: neuronal dysfunction or cell loss. Arch Neurol 58:2048–2053

    Article  PubMed  Google Scholar 

  15. Vermathen P, Ende G, Laxer KD, Knowlton RC, Matson GB, Weiner MW (1997) Hippocampal N-acetylaspartate in neocortical epilepsy and mesial temporal lobe epilepsy. Ann Neurol 42:194–199

    Article  PubMed  Google Scholar 

  16. Kuzniecky R, Hugg J, Hetherington H et al (1999) Predictive value 1H MRSI for outcome in temporal lobe lobectomy. Neurology 53:694–698

    PubMed  Google Scholar 

  17. Li LM, Cendes F, Antel SB et al (2000) Prognostic value of proton magnetic resonance spectroscopic imaging for surgical outcome in patients with intractable temporal lobe epilepsy and bilateral hippocampal atrophy. Ann Neurol 47:195–200

    Article  PubMed  Google Scholar 

  18. Suhy J, Laxer KD, Capizzano AA, Vermathen P, Matson GB, Barbaro NM, Weiner MW (2002) 1H MRSI predicts surgical outcome in MRI-negative temporal lobe epilepsy. Neurology 58:821–823

    PubMed  Google Scholar 

  19. Capizzano AA, Vermathen P, Laxer KD et al (2001) Temporal lobe epilepsy: qualitative reading of 1H MR spectroscopic images for presurgical evaluation. Radiology 218:144–151

    PubMed  Google Scholar 

  20. Duc CO, Trabesinger AH, Weber OM, Meier D, Walder M, Wieser HG, Boesinger P (1998) Quantitative 1H MRS in the evaluation of mesial temporal lobe epilepsy in vivo. Magn Reson Imaging 16:969–979

    Article  PubMed  Google Scholar 

  21. Bernasconi A, Tasch E, Cendes F, Li LM, Arnold DL (2002) Proton magnetic resonance spectroscopic imaging suggest progressive neuronal damage in human temporal lobe epilepsy. Prog Brain Res 135:297–304

    PubMed  Google Scholar 

  22. Mouritzen Dam A (1980) Epilepsy and neuron loss in the hippocampus. Epilepsia 21:617–629

    PubMed  Google Scholar 

  23. Davies KG, Hermann BP, Dohan FC Jr, Foley KT, Bush AJ, Wyler AR (1996) Relationship of hippocampal sclerosis to duration and age of onset of epilepsy, and childhood febrile seizures in temporal lobectomy patients. Epilepsy Res 24:119–126

    Article  PubMed  Google Scholar 

  24. Mathern GW, Pretorius JK, Babb TL (1995) Influence of the type of initial precipitating injury and at what age it occurs on course and outcome in patients with temporal lobe seizures. J Neurosurg 82:220–227

    PubMed  Google Scholar 

  25. Garcia PA, Laxer KD, van der GJ, Hugg JW, Matson GB, Weiner MW (1997) Correlation of seizure frequency with N-acetyl-aspartate levels determined by 1H magnetic resonance spectroscopic imaging. Magn Reson Imaging 15:475–478

    Article  PubMed  Google Scholar 

  26. Epstein CM, Boor D, Hoffman JC et al (1996) Evaluation of 1H magnetic resonance spectroscopic imaging as a diagnostic tool for the lateralization of epileptogenic seizure foci. Br J Radiol 69:15–24

    PubMed  Google Scholar 

  27. Gadian DG, Connelly A, Duncan JS et al (1994) 1H magnetic resonance spectroscopy in the investigation of intractable epilepsy. Acta Neurol Scand Suppl 152:116–121

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Neurology, Seoul National University College of Medicine, Seoul National University Hospital, 28 Yonkeun dong, Chongno ku, Seoul, 110-744, Korea

    S. K. Lee, D. W. Kim & K. K. Kim

  2. Department of Neurosurgery, Seoul National University College of Medicine, Seoul National University Hospital, 28 Yonkeun dong, Chongno ku, Seoul, 110-744, Korea

    C. K. Chung

  3. Department of Radiology, Seoul National University College of Medicine, Seoul National University Hospital, 28 Yonkeun dong, Chongno ku, Seoul, 110-744, Korea

    I. C. Song & K. H. Chang

Authors
  1. S. K. Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. D. W. Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. K. K. Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. C. K. Chung
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. I. C. Song
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. K. H. Chang
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to S. K. Lee.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Lee, S.K., Kim, D.W., Kim, K.K. et al. Effect of seizure on hippocampus in mesial temporal lobe epilepsy and neocortical epilepsy: an MRS study. Neuroradiology 47, 916–923 (2005). https://doi.org/10.1007/s00234-005-1447-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00234-005-1447-8

Keywords

Search

Navigation