A subcortical network of dysfunction in TLE measured by magnetic resonance spectroscopy

H. P. Hetherington, R. I. Kuzniecky, K. Vives, O. Devinsky, S. Pacia, D. Luciano, B. Vasquez, Sheryl R. Haut, D. D. Spencer, J. W. Pan

Research output: Contribution to journalArticle

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Abstract

OBJECTIVE: The goal of this work was to evaluate the relationship between neuronal injury/loss in the hippocampus, thalamus, and putamen in temporal lobe epilepsy (TLE) patients using H magnetic resonance spectroscopic imaging. METHODS: H spectroscopic images from the hippocampus and thalamus of controls and patients with TLE were acquired at 4 T. The spectroscopic imaging data were reconstructed using an automated voxel-shifting method based on anatomic landmarks providing four, six, and three loci for the hippocampus, thalamus, and putamen, respectively. For correlation analysis, the hippocampal and striatal loci were averaged to provide single estimates of the entire structure, whereas the thalamus was divided into two regions, an anterior and posterior measure, using the average of three loci each. RESULTS: The ratio of N-acetyl aspartate to creatine (NAA/Cr), a measure of neuronal injury/loss, was significantly reduced in both the ipsilateral and contralateral hippocampi and thalami. NAA/Cr in the ipsilateral hippocampus was significantly correlated with the ipsilateral and contralateral anterior and posterior thalami, putamen, and contralateral hippocampus. In control subjects, the hippocampi were only correlated with each other. CONCLUSIONS: The data demonstrate that there is significant neuronal injury/loss in both the ipsilateral and contralateral thalami in temporal lobe epilepsy patients, with greater impairment in the anterior portions of the ipsilateral thalamus. The degree of injury/loss in the ipsilateral and contralateral thalamus and putamen is directly correlated with that of the ipsilateral hippocampus. This is consistent with the hypothesis that the impairment and damage associated with recurrent seizures as measured by N-acetyl aspartate originating in the hippocampus results in injury and impairment in other subcortical structures.

Original languageEnglish (US)
Pages (from-to)2256-2265
Number of pages10
JournalNeurology
Volume69
Issue number24
DOIs
StatePublished - Dec 2007

Fingerprint

Temporal Lobe Epilepsy
Thalamus
Hippocampus
Magnetic Resonance Spectroscopy
Putamen
Wounds and Injuries
Creatine
Anatomic Landmarks
Corpus Striatum
Seizures
Magnetic Resonance Imaging

ASJC Scopus subject areas

  • Neuroscience(all)

Cite this

Hetherington, H. P., Kuzniecky, R. I., Vives, K., Devinsky, O., Pacia, S., Luciano, D., ... Pan, J. W. (2007). A subcortical network of dysfunction in TLE measured by magnetic resonance spectroscopy. Neurology, 69(24), 2256-2265. https://doi.org/10.1212/01.wnl.0000286945.21270.6d

A subcortical network of dysfunction in TLE measured by magnetic resonance spectroscopy. / Hetherington, H. P.; Kuzniecky, R. I.; Vives, K.; Devinsky, O.; Pacia, S.; Luciano, D.; Vasquez, B.; Haut, Sheryl R.; Spencer, D. D.; Pan, J. W.

In: Neurology, Vol. 69, No. 24, 12.2007, p. 2256-2265.

Research output: Contribution to journalArticle

Hetherington, HP, Kuzniecky, RI, Vives, K, Devinsky, O, Pacia, S, Luciano, D, Vasquez, B, Haut, SR, Spencer, DD & Pan, JW 2007, 'A subcortical network of dysfunction in TLE measured by magnetic resonance spectroscopy', Neurology, vol. 69, no. 24, pp. 2256-2265. https://doi.org/10.1212/01.wnl.0000286945.21270.6d
Hetherington HP, Kuzniecky RI, Vives K, Devinsky O, Pacia S, Luciano D et al. A subcortical network of dysfunction in TLE measured by magnetic resonance spectroscopy. Neurology. 2007 Dec;69(24):2256-2265. https://doi.org/10.1212/01.wnl.0000286945.21270.6d
Hetherington, H. P. ; Kuzniecky, R. I. ; Vives, K. ; Devinsky, O. ; Pacia, S. ; Luciano, D. ; Vasquez, B. ; Haut, Sheryl R. ; Spencer, D. D. ; Pan, J. W. / A subcortical network of dysfunction in TLE measured by magnetic resonance spectroscopy. In: Neurology. 2007 ; Vol. 69, No. 24. pp. 2256-2265.
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AU - Hetherington, H. P.

AU - Kuzniecky, R. I.

AU - Vives, K.

AU - Devinsky, O.

AU - Pacia, S.

AU - Luciano, D.

AU - Vasquez, B.

AU - Haut, Sheryl R.

AU - Spencer, D. D.

AU - Pan, J. W.

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N2 - OBJECTIVE: The goal of this work was to evaluate the relationship between neuronal injury/loss in the hippocampus, thalamus, and putamen in temporal lobe epilepsy (TLE) patients using H magnetic resonance spectroscopic imaging. METHODS: H spectroscopic images from the hippocampus and thalamus of controls and patients with TLE were acquired at 4 T. The spectroscopic imaging data were reconstructed using an automated voxel-shifting method based on anatomic landmarks providing four, six, and three loci for the hippocampus, thalamus, and putamen, respectively. For correlation analysis, the hippocampal and striatal loci were averaged to provide single estimates of the entire structure, whereas the thalamus was divided into two regions, an anterior and posterior measure, using the average of three loci each. RESULTS: The ratio of N-acetyl aspartate to creatine (NAA/Cr), a measure of neuronal injury/loss, was significantly reduced in both the ipsilateral and contralateral hippocampi and thalami. NAA/Cr in the ipsilateral hippocampus was significantly correlated with the ipsilateral and contralateral anterior and posterior thalami, putamen, and contralateral hippocampus. In control subjects, the hippocampi were only correlated with each other. CONCLUSIONS: The data demonstrate that there is significant neuronal injury/loss in both the ipsilateral and contralateral thalami in temporal lobe epilepsy patients, with greater impairment in the anterior portions of the ipsilateral thalamus. The degree of injury/loss in the ipsilateral and contralateral thalamus and putamen is directly correlated with that of the ipsilateral hippocampus. This is consistent with the hypothesis that the impairment and damage associated with recurrent seizures as measured by N-acetyl aspartate originating in the hippocampus results in injury and impairment in other subcortical structures.

AB - OBJECTIVE: The goal of this work was to evaluate the relationship between neuronal injury/loss in the hippocampus, thalamus, and putamen in temporal lobe epilepsy (TLE) patients using H magnetic resonance spectroscopic imaging. METHODS: H spectroscopic images from the hippocampus and thalamus of controls and patients with TLE were acquired at 4 T. The spectroscopic imaging data were reconstructed using an automated voxel-shifting method based on anatomic landmarks providing four, six, and three loci for the hippocampus, thalamus, and putamen, respectively. For correlation analysis, the hippocampal and striatal loci were averaged to provide single estimates of the entire structure, whereas the thalamus was divided into two regions, an anterior and posterior measure, using the average of three loci each. RESULTS: The ratio of N-acetyl aspartate to creatine (NAA/Cr), a measure of neuronal injury/loss, was significantly reduced in both the ipsilateral and contralateral hippocampi and thalami. NAA/Cr in the ipsilateral hippocampus was significantly correlated with the ipsilateral and contralateral anterior and posterior thalami, putamen, and contralateral hippocampus. In control subjects, the hippocampi were only correlated with each other. CONCLUSIONS: The data demonstrate that there is significant neuronal injury/loss in both the ipsilateral and contralateral thalami in temporal lobe epilepsy patients, with greater impairment in the anterior portions of the ipsilateral thalamus. The degree of injury/loss in the ipsilateral and contralateral thalamus and putamen is directly correlated with that of the ipsilateral hippocampus. This is consistent with the hypothesis that the impairment and damage associated with recurrent seizures as measured by N-acetyl aspartate originating in the hippocampus results in injury and impairment in other subcortical structures.

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