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Sci Transl Med. 2015 Oct 14;7(309):309ra161. doi: 10.1126/scitranslmed.aaa7095.

Glutamate imaging (GluCEST) lateralizes epileptic foci in nonlesional temporal lobe epilepsy.

Author information

1
Penn Epilepsy Center, Department of Neurology, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA.
2
Center for Magnetic Resonance & Optical Imaging, Department of Radiology, University of Pennsylvania, Philadelphia, PA 19104, USA.
3
Penn Image Computing & Science Lab, University of Pennsylvania, Philadelphia, PA 19104, USA.
4
Department of Neurosurgery, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA.
5
Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, PA 19104, USA.

Abstract

When neuroimaging reveals a brain lesion, drug-resistant epilepsy patients show better outcomes after resective surgery than do the one-third of drug-resistant epilepsy patients who have normal brain magnetic resonance imaging (MRI). We applied a glutamate imaging method, GluCEST (glutamate chemical exchange saturation transfer), to patients with nonlesional temporal lobe epilepsy based on conventional MRI. GluCEST correctly lateralized the temporal lobe seizure focus on visual and quantitative analyses in all patients. MR spectra, available for a subset of patients and controls, corroborated the GluCEST findings. Hippocampal volumes were not significantly different between hemispheres. GluCEST allowed high-resolution functional imaging of brain glutamate and has potential to identify the epileptic focus in patients previously deemed nonlesional. This method may lead to improved clinical outcomes for temporal lobe epilepsy as well as other localization-related epilepsies.

PMID:
26468323
PMCID:
PMC4710355
DOI:
10.1126/scitranslmed.aaa7095
[Indexed for MEDLINE]
Free PMC Article

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