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Magnetic resonance spectroscopy reveals an epileptic network in juvenile myoclonic epilepsy.
Lin, Katia; Carrete, Henrique; Lin, Jaime; Peruchi, Mirella Maccarini; de Araújo Filho, Gerardo Maria; Guaranha, Mirian Salvadori Bittar; Guilhoto, Laura Maria Figueiredo Ferreira; Sakamoto, Américo Ceiki; Yacubian, Elza Márcia Targas.
Afiliación
  • Lin K; Unidade de Pesquisa e Tratamento das Epilepsias (UNIPETE), Universidade Federal de São Paulo (UNIFESP/EPM), São Paulo, SP, Brazil. linkatia@uol.com.br
Epilepsia ; 50(5): 1191-200, 2009 May.
Article en En | MEDLINE | ID: mdl-19220412
PURPOSE: To investigate the cerebral metabolic differences between patients with juvenile myoclonic epilepsy (JME) and normal controls and to evaluate to what extent these metabolic alterations reflect involvement of an epileptic network. METHODS: Sixty patients with JME were submitted to multi-voxel proton spectroscopy (1H-MRS) at 1.5 T over medial prefrontal cortex (MPC), primary motor cortex (PMC), thalamus, striatum, posterior cingulate gyrus (PCG), and insular, parietal, and occipital cortices. We determined ratios for integral values of N-acetyl-aspartate (NAA) and glutamate-glutamine (GLX) over creatine-phosphocreatine (Cr). The control group (CTL) consisted of 30 age- and sex-matched healthy volunteers. RESULTS: The NAA/Cr ratio, a measure of neuronal injury, was reduced in PMC, MPC, and thalamus among patients. In addition, they had an altered GLX/Cr ratio, which is involved in excitatory activity, on PMC, MPC, and PCG, where it was reduced, whereas it was increased on insula and striatum. Multiple regression analysis revealed the strongest correlation between thalamus and MPC, but the thalamus was also correlated with insula, occipital cortex, and striatum among patients. Lower NAA/Cr was observed with advancing age and duration of epilepsy, regardless of frequency of seizures and antiepileptic drug therapy in thalamus and frontal cortex. DISCUSSION: The identification of a specific network of neurochemical dysfunction in patients with JME, with diverse involvement of particular structures within the thalamocortical circuitry, suggests that cortical hyperexcitability in JME is not necessarily diffuse, supporting the knowledge that the focal/generalized distinction of epileptogenesis should be reconsidered. Furthermore, evidence is provided toward progressive neuronal dysfunction in JME.
Asunto(s)

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Encéfalo / Epilepsia Mioclónica Juvenil Tipo de estudio: Observational_studies / Prognostic_studies Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Epilepsia Año: 2009 Tipo del documento: Article País de afiliación: Brasil

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Encéfalo / Epilepsia Mioclónica Juvenil Tipo de estudio: Observational_studies / Prognostic_studies Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Epilepsia Año: 2009 Tipo del documento: Article País de afiliación: Brasil