Correlation between memory, proton magnetic resonance spectroscopy, and interictal epileptiform discharges in temporal lobe epilepsy related to mesial temporal sclerosis.

Department of Neurology and Neurosurgery, Division of Neurology, Universidade Federal de São Paulo/UNIFESP, São Paulo, Brazil.
Epilepsy & Behavior (Impact Factor: 2.06). 11/2009; 16(3):447-53. DOI: 10.1016/j.yebeh.2009.08.032
Source: PubMed

ABSTRACT The aim of the study described here was to examine the relationship between memory function, proton magnetic resonance spectroscopy ((1)H-MRS) abnormalities, and interictal epileptiform discharge (IED) lateralization in patients with temporal lobe epilepsy (TLE) related to unilateral mesial temporal sclerosis.
We assessed performance on tests of memory function and intelligence quotient (IQ) in 29 right-handed outpatients and 24 controls. IEDs were assessed on 30-minute-awake and 30-minute-sleep EEG samples. Patients had (1)H-MRS at 1.5 T.
There was a negative correlation between IQ (P=0.031) and Rey Auditory Verbal Learning Test results (P=0.022) and epilepsy duration; between(1)H-MRS findings and epilepsy duration (P=0.027); and between N-acetylaspartate (NAA) levels and IEDs (P=0.006) in contralateral mesial temporal structures in the left MTS group. (1)H-MRS findings, IEDs, and verbal function were correlated.
These findings suggest that IEDs and NAA/(Cho+Cr) ratios reflecting neural metabolism are closely related to verbal memory function in mesial temporal sclerosis. Higher interictal activity on the EEG was associated with a decline in total NAA in contralateral mesial temporal structures.

Download full-text


Available from: Katia Lin, Jun 18, 2015
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Cognitive impairment is the most common comorbidity in children with epilepsy, but its pathophysiology and predisposing conditions remain unknown. Clinical epilepsy characteristics are not conclusive in determining cognitive outcome. Because many children with epilepsy do not have macrostructural magnetic resonance imaging (MRI) abnormalities, the underlying substrate for cognitive impairment may be found at the microstructural or functional level. In the last two decades, new MRI techniques have been developed that have the potential to visualize microstructural or functional abnormalities associated with cognitive impairment. These include volumetric MRI, voxel-based morphometry (VBM), diffusion tensor imaging (DTI), MR spectroscopy (MRS), and functional MRI (fMRI). All of these techniques have shed new light on various aspects associated with, or underlying, cognitive impairment, although their use in epilepsy has been limited and focused mostly on adults. Therefore, in this review, the use of all these different MRI techniques to unravel cognitive impairment in epilepsy is discussed both in adults and children with epilepsy. Volumetric MRI and VBM have revealed significant volume losses in the area of the seizure focus as well as in distant areas. DTI adds evidence of loss of integrity of connections from the seizure focus to distant areas as well as between distant areas. MRS and fMRI have shown impaired function both in the area of the seizure focus as well as in distant structures. For this review we have compiled and compared findings from the various techniques to conclude that cognitive impairment in epilepsy results from a network disorder in which the (micro)structures as well as the functionality can be disturbed.
    Epilepsia 08/2012; 53(10):1690-9. DOI:10.1111/j.1528-1167.2012.03624.x · 4.58 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Summary form only given. In this paper, we present a novel synchronized technique based on the fs KLM Ti:sapphire and Cr:forsterite lasers, in which timing jitter of less than 1 fs was demonstrated within the measurement accuracy. The schematic of the experimental setup consists of prism dispersion controlled KLM Ti:sapphire and Cr:forsterite lasers. In order to induce a strong nonlinear coupling effect for synchronization, we used two pairs of D-shaped concave mirrors to focus and cross both laser beams inside the Ti:sapphire crystal. With 5 W 532 nm and 9 W 1064 nm pump lasers, stable mode-locking powers of 600 mW and 150 mW were produced from the Ti:sapphire and Cr:forsterite lasers, respectively.
    Lasers and Electro-Optics, 2002. CLEO '02. Technical Digest. Summaries of Papers Presented at the; 02/2002
  • [Show abstract] [Hide abstract]
    ABSTRACT: We evaluated the reliability and validity of a Brazilian-Portuguese version of the Epilepsy Medication Treatment Complexity Index (EMTCI). Interrater reliability was evaluated with the intraclass correlation coefficient (ICC), and validity was evaluated by correlation of mean EMTCI scores with the following variables: number of antiepileptic drugs (AEDs), seizure control, patients' perception of seizure control, and adherence to the therapeutic regimen as measured with the Morisky scale. We studied patients with epilepsy followed in a tertiary university-based hospital outpatient clinic setting, aged 18 years or older, independent in daily living activities, and without cognitive impairment or active psychiatric disease. ICCs ranged from 0.721 to 0.999. Mean EMTCI scores were significantly correlated with the variables assessed. Higher EMTCI scores were associated with an increasing number of AEDs, uncontrolled seizures, patients' perception of lack of seizure control, and poorer adherence to the therapeutic regimen. The results indicate that the Brazilian-Portuguese EMTCI is reliable and valid to be applied clinically in the country. The Brazilian-Portuguese EMTCI version may be a useful tool in developing strategies to minimize treatment complexity, possibly improving seizure control and quality of life in people with epilepsy in our milieu.
    Epilepsy & Behavior 06/2011; 21(4):467-72. DOI:10.1016/j.yebeh.2011.04.054 · 2.06 Impact Factor