1H AND 31P MRSI FOR EPILEPSY LOCALIZATION

Summary

Principal Investigator: Kenneth Laxer
Affiliation: California Pacific Medical Center
Country: USA
Abstract: The long term goal of this application is to improve the outcome of seizure surgery by better presurgical localization of medically refractory epilepsy using a combination of neuroimaging techniques including magnetic resonance imaging (MRI), 1H and 31P MR spectroscopic imaging (MRSI), and 18F-PET. These techniques will be directed at three groups with medically refractory epilepsy who are being evaluated for seizure surgery (numbers for 5 years): 1)patients with medial temporal lobe epilepsy in whom MRI is non-concordant i.e., MRI shows no abnormality, or an abnormality contralateral to the EEG-defined seizure focus (NC-mTLE, n=75), 2) patients with non-lesional neocortical epilepsy (NE, n=100), and 3) children with Infantile Spasms (IS, n=100). NC-mTLE and NE patients frequently require invasive EEG recording, have less than a 50 percent probability of becoming seizure free with surgery, and are often not considered for surgery. Post-operative surgical outcome will be analyzed in relation to the pre-operative neuroimaging findings. Hypotheses: 1) NC-mTLE -Patients with medically refractory mTLE without MRI concordance, who have 1H and 31P MRSI measures concordant with the EEG localization (i.e., lobe and side), will have a significantly better post surgical outcome than patients without MRSI concordance. 2a) NE - NE patients without lesions on MRI, will have 1H and 31P MRSI concordant with the EEG localization (i.e., lobe and side), and this concordance will be greater than that provided by 18FDG-PET. 2b) NE - NE patients, who have 1H and 31P MRSI measures concordant with the EEG localization will have a significantly better post surgical outcome than patients without MRSI concordance. 3a) IS - Children with medically refractory Infantile Spasms will have 1H and 31P MRSI concordant with the seizure focus determined by a combination of two or more studies (VET, 18FDG-PET, and/or MRI) and this concordance will be greater than that provided by MRI or 18FDG-PET. 3b) IS - IS children, who have 1H and 31P MRSI concordant with the localization provided by the other clinical and imaging studies will have a significantly better post surgical outcome than patients without such concordance. These studies are expected to lead to improved surgical outcome, and to reduce unnecessary surgery, in patients with intractable epilepsy.
Funding Period: 1994-05-01 - 2005-03-31
more information: NIH RePORT

Top Publications

  1. pmc Grey and white matter abnormalities in temporal lobe epilepsy with and without mesial temporal sclerosis
    Cathy Scanlon
    Center for Imaging of Neurodegenerative Diseases and Department of Radiology, University of California, San Francisco, CA, USA
    J Neurol 260:2320-9. 2013
  2. pmc A two-level multimodality imaging Bayesian network approach for classification of partial epilepsy: preliminary data
    Susanne G Mueller
    Center for Imaging of Neurodegenerative Diseases, VA Medical Center, San Francisco, USA
    Neuroimage 71:224-32. 2013
  3. pmc Treatment with cholinesterase inhibitors and memantine of patients in the Alzheimer's Disease Neuroimaging Initiative
    Lon S Schneider
    Department of Psychiatry and the Behavioral Sciences, University of Southern California Keck School of Medicine, Los Angeles, CA 90033, USA
    Arch Neurol 68:58-66. 2011
  4. doi Is antiepileptic drug use related to depression and suicidal ideation among patients with epilepsy?
    X Wen
    Department of Pharmaceutical Outcomes and Policy, University of Florida, Gainesville, FL, USA
    Epilepsy Behav 19:494-500. 2010
  5. pmc Comparing predictors of conversion and decline in mild cognitive impairment
    S M Landau
    Helen Wills Neuroscience Institute, University of California, Berkeley 94720 3190, USA
    Neurology 75:230-8. 2010
  6. pmc Serial MRI and CSF biomarkers in normal aging, MCI, and AD
    P Vemuri
    Aging and Dementia Imaging Research Laboratory, Department of Radiology, Mayo Clinic and Foundation, Rochester, MN 55905, USA
    Neurology 75:143-51. 2010
  7. pmc Widespread extrahippocampal NAA/(Cr+Cho) abnormalities in TLE with and without mesial temporal sclerosis
    Susanne G Mueller
    Center for Imaging of Neurodegenerative Diseases and Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA
    J Neurol 258:603-12. 2011
  8. pmc Impact of apolipoprotein E4-cerebrospinal fluid β-amyloid interaction on hippocampal volume loss over 1 year in mild cognitive impairment
    Gloria C Chiang
    Department of Radiology, University of California, San Francisco, USA
    Alzheimers Dement 7:514-20. 2011
  9. pmc Amyloid pathway-based candidate gene analysis of [(11)C]PiB-PET in the Alzheimer's Disease Neuroimaging Initiative (ADNI) cohort
    Shanker Swaminathan
    Department of Radiology and Imaging Sciences, Center for Neuroimaging, Indiana University School of Medicine, Indianapolis, IN, USA
    Brain Imaging Behav 6:1-15. 2012
  10. pmc Gray matter perfusion correlates with disease severity in ALS
    Randall R Rule
    4150 Clement Street 114Q, San Francisco, CA 94121, USA
    Neurology 74:821-7. 2010

Scientific Experts

Detail Information

Publications22

  1. pmc Grey and white matter abnormalities in temporal lobe epilepsy with and without mesial temporal sclerosis
    Cathy Scanlon
    Center for Imaging of Neurodegenerative Diseases and Department of Radiology, University of California, San Francisco, CA, USA
    J Neurol 260:2320-9. 2013
    ..The microstructural organization in the corpus callosum was related to hippocampal volume in both patients and healthy subjects demonstrating the association of these distal regions...
  2. pmc A two-level multimodality imaging Bayesian network approach for classification of partial epilepsy: preliminary data
    Susanne G Mueller
    Center for Imaging of Neurodegenerative Diseases, VA Medical Center, San Francisco, USA
    Neuroimage 71:224-32. 2013
    ....
  3. pmc Treatment with cholinesterase inhibitors and memantine of patients in the Alzheimer's Disease Neuroimaging Initiative
    Lon S Schneider
    Department of Psychiatry and the Behavioral Sciences, University of Southern California Keck School of Medicine, Los Angeles, CA 90033, USA
    Arch Neurol 68:58-66. 2011
    ..To assess the clinical characteristics and course of patients with mild cognitive impairment (MCI) and mild Alzheimer disease (AD) treated with cholinesterase inhibitors (ChEIs) and memantine hydrochloride...
  4. doi Is antiepileptic drug use related to depression and suicidal ideation among patients with epilepsy?
    X Wen
    Department of Pharmaceutical Outcomes and Policy, University of Florida, Gainesville, FL, USA
    Epilepsy Behav 19:494-500. 2010
    ..Significant improvements in proportions of depression and suicidal ideation were seen only for the No AED Change group, which differed only with the AED Dose Increased group with respect to suicidal ideation...
  5. pmc Comparing predictors of conversion and decline in mild cognitive impairment
    S M Landau
    Helen Wills Neuroscience Institute, University of California, Berkeley 94720 3190, USA
    Neurology 75:230-8. 2010
    ..The goal of this study was to evaluate the prognostic ability of genetic, CSF, neuroimaging, and cognitive measurements obtained in the same participants...
  6. pmc Serial MRI and CSF biomarkers in normal aging, MCI, and AD
    P Vemuri
    Aging and Dementia Imaging Research Laboratory, Department of Radiology, Mayo Clinic and Foundation, Rochester, MN 55905, USA
    Neurology 75:143-51. 2010
    ..Comparisons were based on intergroup discrimination, correlation with concurrent cognitive/functional changes, relationships to APOE genotype, and sample sizes for clinical trials...
  7. pmc Widespread extrahippocampal NAA/(Cr+Cho) abnormalities in TLE with and without mesial temporal sclerosis
    Susanne G Mueller
    Center for Imaging of Neurodegenerative Diseases and Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA
    J Neurol 258:603-12. 2011
    ..This reduces their value for focus lateralization and suggests a heterogeneous etiology of extrahippocampal spectroscopic metabolic abnormalities in TLE...
  8. pmc Impact of apolipoprotein E4-cerebrospinal fluid β-amyloid interaction on hippocampal volume loss over 1 year in mild cognitive impairment
    Gloria C Chiang
    Department of Radiology, University of California, San Francisco, USA
    Alzheimers Dement 7:514-20. 2011
    ..No studies have considered the effects of amyloid pathology and APOE ɛ4 together on longitudinal volume loss...
  9. pmc Amyloid pathway-based candidate gene analysis of [(11)C]PiB-PET in the Alzheimer's Disease Neuroimaging Initiative (ADNI) cohort
    Shanker Swaminathan
    Department of Radiology and Imaging Sciences, Center for Neuroimaging, Indiana University School of Medicine, Indianapolis, IN, USA
    Brain Imaging Behav 6:1-15. 2012
    ..Pathway-based genetic analysis of targeted molecular imaging phenotypes appears promising to help elucidate disease pathophysiology and identify potential therapeutic targets...
  10. pmc Gray matter perfusion correlates with disease severity in ALS
    Randall R Rule
    4150 Clement Street 114Q, San Francisco, CA 94121, USA
    Neurology 74:821-7. 2010
    ..The presence of such a relationship would indicate a possible role for ASL perfusion as a marker of disease severity and upper motor neuron involvement in ALS...
  11. pmc Involvement of the thalamocortical network in TLE with and without mesiotemporal sclerosis
    Susanne G Mueller
    Center for Imaging of Neurodegenerative Diseases, San Francisco, California, USA
    Epilepsia 51:1436-45. 2010
    ..This study investigated how structural abnormalities in the focus, ipsilateral thalamus and extrafocal cortical structures relate to each other in TLE with mesiotemporal sclerosis (TLE-MTS) and without hippocampal sclerosis (TLE-no)...
  12. pmc Alzheimer's Disease Neuroimaging Initiative (ADNI): clinical characterization
    R C Petersen
    Department of Neurology, Mayo Clinic College of Medicine, Rochester, MN 55905, USA
    Neurology 74:201-9. 2010
    ..Neuroimaging measures and chemical biomarkers may be important indices of clinical progression in normal aging and mild cognitive impairment (MCI) and need to be evaluated longitudinally...
  13. ncbi Limitations of Wada memory asymmetry as a predictor of outcomes after temporal lobectomy
    H E Kirsch
    UCSF Epilepsy Center, Department of Neurology, University of California, School of Medicine, San Francisco, CA, USA
    Neurology 65:676-80. 2005
    ..Both degree and direction of Wada memory asymmetry (WMA) have been associated with worse surgical outcome in small series. Reports also suggest that UA is associated with greater decline in verbal memory after left ATL (L-ATL)...
  14. pmc Spectroscopic evidence of hippocampal abnormalities in neocortical epilepsy
    S G Mueller
    Department of Veterans Affairs DVA Medical Center, Magnetic Resonance Unit, San Francisco, CA, USA
    Eur J Neurol 13:256-60. 2006
    ..Evidence for unilateral hippocampal damage/dysfunction was demonstrated in 50% of the NE patients. The type of NE, i.e. NE-Les or NE-no, NE-T or NE-ET, had no influence on the occurrence of hippocampal damage/dysfunction...
  15. pmc Voxel-based optimized morphometry (VBM) of gray and white matter in temporal lobe epilepsy (TLE) with and without mesial temporal sclerosis
    Suzanne G Mueller
    Center for Imaging of Neurodegenerative Diseases, VAMC San Francisco, San Francisco, CA, USA
    Epilepsia 47:900-7. 2006
    ....
  16. pmc Voxel-based T2 relaxation rate measurements in temporal lobe epilepsy (TLE) with and without mesial temporal sclerosis
    Susanne G Mueller
    Center for Imaging of Neurodegenerative Diseases, VAMC San Francisco, California, USA
    Epilepsia 48:220-8. 2007
    ..Therefore, the aim of this study was to characterize extent and distribution pattern of extrahippocampal relaxation abnormalities in TLE with (TLE-MTS) and without MRI evidence of mesial-temporal sclerosis (TLE-no)...
  17. ncbi Accelerated 3D echo-planar spectroscopic imaging at 4 Tesla using modified blipped phase-encoding
    Andreas Ebel
    Northern California Institute for Research and Education, Department of Radiology, University of California San Francisco, Department of Veterans Affairs Medical Center San Francisco, San Francisco, California 94121, USA
    Magn Reson Med 58:1061-6. 2007
    ..While the proposed method allows substantial reduction in metabolite ghosting, it may be limited by the presence of a relatively large spurious signal at the Nyquist frequency...
  18. pmc Widespread neocortical abnormalities in temporal lobe epilepsy with and without mesial sclerosis
    S G Mueller
    Center for Imaging of Neurodegenerative Diseases and Department of Radiology, University of California, San Francisco, CA 94121, USA
    Neuroimage 46:353-9. 2009
    ..The aim of this study was to seek and characterize patterns of cortical thinning in TLE-MTS and TLE-no...
  19. pmc Subfield atrophy pattern in temporal lobe epilepsy with and without mesial sclerosis detected by high-resolution MRI at 4 Tesla: preliminary results
    Susanne G Mueller
    Department of Radiology, Center for Imaging of Neurodegenerative Diseases, University of California, San Francisco, California 94121, USA
    Epilepsia 50:1474-83. 2009
    ..The aim of this study was to test if distinct subfield atrophy patterns can be detected in temporal lobe epilepsy (TLE) with mesial temporal sclerosis (TLE-MTS) and without (TLE-no) hippocampal sclerosis...
  20. pmc Relationships between biomarkers in aging and dementia
    W J Jagust
    Helen Wills Neuroscience Institute, University of California, Berkeley, CA 94620, USA
    Neurology 73:1193-9. 2009
    ..Relationships between biomarkers and with disease severity are incompletely understood...
  21. pmc Testing the limits: cautions and concerns regarding the new Wechsler IQ and Memory scales
    David W Loring
    Department of Neurology, Emory University, 101 Woodruff Circle, Suite 6000, Atlanta, GA, USA
    Neurology 74:685-90. 2010
    ....
  22. pmc Metabolic characteristics of cortical malformations causing epilepsy
    S G Mueller
    Dept of Veterans Affairs DVA, Medical Center, Magnetic Resonance Spectroscopy Unit, San Francisco, CA 94115, USA
    J Neurol 252:1082-92. 2005
    ..The aim of this study was to test the hypotheses that: 1. CMs are metabolically heterogeneous. 2. The structurally normal appearing perilesional zone is characterized by similar metabolic abnormalities as the CM...