Extratemporal abnormalities in phosphorus magnetic resonance spectroscopy of patients with mesial temporal sclerosis

ABSTRACT

Objective We evaluated extratemporal metabolic changes with phosphorus magnetic resonance spectroscopy (³¹P-MRS) in patients with unilateral mesial temporal sclerosis (MTS).

Method ³¹P-MRS of 33 patients with unilateral MTS was compared with 31 controls. The voxels were selected in the anterior, posterior insula-basal ganglia (AIBG, PIBG) and frontal lobes (FL). Relative values of phosphodiesters- PDE, phosphomonoesters-PME, inorganic phosphate - Pi, phosphocreatine- PCr, total adenosine triphosphate [ATP_{t =} γ- + a- + b-ATP] and the ratios PCr/ATP_t, PCr/γ-ATP, PCr/Pi and PME/PDE were obtained.

Results We found energetic abnormalities in the MTS patients compared to the controls with Pi reduction bilaterally in the AIBG and ipsilaterally in the PIBG and the contralateral FL; there was also decreased PCr/γ-ATP in the ipsilateral AIBG and PIBG. Increased ATP_T in the contralateral AIBG and increased γ-ATP in the ipsilateral PIBG were detected.

Conclusion Widespread energy dysfunction was detected in patients with unilateral MTS.

RESUMO

Objetivo Nós avaliamos as alterações metabóblicas através da espectroscopia de fósforo por ressonância magnética (³¹P-MRS) em pacientes com esclerose mesial temporal (EMT) unilateral.

Método ³¹P-MRS de 33 pacientes com EMT unilateral foram comparadas aos de 31 controles. Foram selecionados os voxels nas regiões insulonuclear anterior e posterior (RINA e RINP) e frontal (RF). Os valores relativos de fosfodiésteres – PDE, fosfomonoésteres- PME, fosfato inorgânico- Pi, fosfocreatina –PCr, adenosina trifosfato total [ATP_{t =} γ- + a- + b-ATP] e as razões PCr/ATP_t, PCr/γ-ATP, PCr/Pi e PME/PDE foram obtidas.

Resultados Nós encontramos anormalidades em pacientes com EMT em comparação aos controles. Redução de Pi nas RINA bilateralmente, RINP ipsilateral e RF contralateral, redução de PCr/γ-ATP nas RINA e RINP ipsilaterais foram detectadas. Aumentos de ATP_T na RINA contralateral e aumento de γ-ATP na RINP ipsilateral também foram encontradas.

Conclusão Disfunção energética difusa foi encontrada em pacientes com EMT unilateral.

phosphorus spectroscopy - magnetic resonance imaging - neurometabolism - mesial temporal sclerosis - epilepsy

espectroscopia de fósforo - ressonância magnética - neurometabolismo - esclerose mesial temporal - epilepsia

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