caa a22 4500 445847875 CHVBK 20180317145404.0 cr unu---uuuuu 170323e20110101xx s 000 0 eng 10.1007/s10548-010-0156-8 doi (NATIONALLICENCE)springer-10.1007/s10548-010-0156-8 Magnetoencephalographic and Magnetic Resonance Spectroscopy Evidence of Regional Functional Abnormality in Mesial Temporal Lobe Epilepsy [Elektronische Daten] [Jerry Shih, Michael Weisend, John Sanders, Roland Lee] Mesial temporal lobe epilepsy (mTLE) with mesial temporal sclerosis (MTS) is a recognized epilepsy syndrome which is successfully treated with mesial temporal lobe resection. However, recent studies suggest that mTLE is more than a "focal” disease process. The objective of our study was to determine the presence and extent of functional abnormalities outside of a defined structural abnormality in epilepsy patients with mTLE. We used a prospective age-matched controlled design to study eight consecutive patients with MTS who were undergoing epilepsy surgery evaluation. Magnetoencephalography was used to localize the sources of electromagnetic abnormality. Proton magnetic resonance spectroscopy (1H-MRS) measured integrated peak areas for N-acetyl compounds (NAA) and choline-containing compounds (Cho) to determine regions of metabolic abnormality. All eight subjects had predominant electromagnetic abnormality in the temporal lobe ipsilateral to the MTS. All eight subjects had lower NAA/Cho ratios in the region of electromagnetic abnormality when compared to the homologous contralateral region (P<0.001). Four subjects had predominant MEG spiking outside the mesial temporal region. Surgery-free outcome for the group with neuroimaging abnormalities outside of the medial temporal lobe is 50%. The region of maximal electromagnetic abnormality is outside the hippocampus in some patients with mTLE. These regions also demonstrate functional abnormalities. Our findings support the concept that mTLE is a more diffuse process than the hippocampal structural abnormality, which may impact surgical outcome. Springer Science+Business Media, LLC, 2010 Epilepsy nationallicence Magnetoencephalography nationallicence Magnetic resonance spectroscopy nationallicence Shih Jerry Department of Neurology, Mayo Clinic, 4500 San Pablo Road, 32224, Jacksonville, FL, USA aut Weisend Michael The MIND Research Network, Albuquerque, NM, USA aut Sanders John Colorado Springs Health Partners, Colorado Springs, CO, USA aut Lee Roland Department of Radiology, UCSD and VA San Diego, San Diego, CA, USA aut Brain Topography Springer US; http://www.springer-ny.com 23/4(2011-01-01), 368-374 0896-0267 23:4<368 2011 23 10548 https://doi.org/10.1007/s10548-010-0156-8 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s10548-010-0156-8 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Shih Jerry Department of Neurology, Mayo Clinic, 4500 San Pablo Road, 32224, Jacksonville, FL, USA aut NATIONALLICENCE 700 1- Weisend Michael The MIND Research Network, Albuquerque, NM, USA aut NATIONALLICENCE 700 1- Sanders John Colorado Springs Health Partners, Colorado Springs, CO, USA aut NATIONALLICENCE 700 1- Lee Roland Department of Radiology, UCSD and VA San Diego, San Diego, CA, USA aut NATIONALLICENCE 773 0- Brain Topography Springer US; http://www.springer-ny.com 23/4(2011-01-01), 368-374 0896-0267 23:4<368 2011 23 10548 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer