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

Park, Eun Joo; Otaduy, Maria Concepción Garcia; Lyra, Katarina Paz de; Andrade, Celi Santos; Castro, Luiz Henrique Martins; Passarelli, Valmir; Valerio, Rosa Maria Figueiredo; Jorge, Carmen Lisa; Tsunemi, Miriam Harumi; Leite, Claudia da Costa

doi:10.1590/0004-282X20160005

Brasil

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Articles • Arq. Neuro-Psiquiatr. 74 (2) • Feb 2016 • https://doi.org/10.1590/0004-282X20160005 linkcopy

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

Anormalidades extratemporais na espectroscopia de fósforo por ressonância magnética em pacientes com esclerose mesial temporal

Authorship SCIMAGO INSTITUTIONS RANKINGS

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.

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

Location	Metabolites and ratios	Patients		Controls		p-value

		mean	SD	mean	SD
AIBG	Pi	0.081	0.013	0.089	0.007	0.009
	PCr	0.194	0.017	0.198	0.014	0.289
	γ-ATP	0.100	0.014	0.094	0.011	0.071
	ATP_T	0.293	0.022	0.286	0.018	0.165
	PCr/ATP_T	0.668	0.100	0.699	0.081	0.183
	PCr/γ-ATP	1.966	0.310	2.146	0.327	0.027
	PCr/Pi	2.465	0.599	2.264	0.235	0.081
	PME	0.173	0.017	0.174	0.014	0.706
	PDE	0.196	0.018	0.194	0.015	0.616
	PME/PDE	0.889	0.133	0.903	0.086	0.604
PIBG	Pi	0.077	0.011	0.083	0.008	0.009
	PCr	0.197	0.017	0.200	0.012	0.520
	γ-ATP	0.098	0.009	0.093	0.009	0.024
	ATP_T	0.294	0.019	0.286	0.019	0.080
	PCr/ATP_T	0.674	0.085	0.704	0.075	0.132
	PCr/γ-ATP	2.023	0.249	2.194	0.306	0.017
	PCr/Pi	2.629	0.533	2.437	0.303	0.081
	PME	0.167	0.013	0.168	0.011	0.739
	PDE	0.206	0.015	0.207	0.016	0.736
	PME/PDE	0.817	0.088	0.819	0.082	0.929
FL	Pi	0.088	0.012	0.093	0.010	0.106
	PCr	0.195	0.021	0.195	0.015	0.941
	γ-ATP	0.102	0.014	0.101	0.011	0.977
	ATP_T	0.296	0.019	0.303	0.016	0.121
	PCr/ATP_T	0.663	0.107	0.645	0.069	0.420
	PCr/γ-ATP	1.969	0.418	1.957	0.303	0.892
	PCr/Pi	2.252	0.443	2.139	0.279	0.233
	PME	0.175	0.017	0.173	0.012	0.689
	PDE	0.185	0.018	0.180	0.016	0.261
	PME/PDE	0.954	0.131	0.971	0.099	0.560

Location	Metabolites and ratios	Patients		Controls		p-value

		mean	SD	mean	SD
AIBG	Pi	0.082	0.011	0.089	0.007	0.013
	PCr	0.194	0.017	0.198	0.014	0.369
	γ-ATP	0.099	0.013	0.094	0.011	0.101
	ATP_T	0.298	0.025	0.286	0.018	0.026
	PCr/ATP_T	0.659	0.105	0.699	0.081	0.096
	PCr/γ-ATP	1.996	0.376	2.146	0.327	0.095
	PCr/Pi	2.409	0.447	2.264	0.235	0.108
	PME	0.172	0.016	0.174	0.016	0.434
	PDE	0.197	0.021	0.194	0.019	0.506
	PME/PDE	0.886	0.163	0.903	0.104	0.184
PIBG	Pi	0.082	0.010	0.083	0.008	0.488
	PCr	0.195	0.015	0.200	0.012	0.219
	γ-ATP	0.096	0.013	0.093	0.009	0.300
	ATP_T	0.296	0.024	0.286	0.019	0.074
	PCr/ATP_T	0.668	0.100	0.704	0.075	0.103
	PCr/γ-ATP	2.087	0.403	2.194	0.306	0.240
	PCr/Pi	2.424	0.372	2.437	0.303	0.879
	PME	0.167	0.014	0.168	0.011	0.601
	PDE	0.206	0.019	0.207	0.016	0.877
	PME/PDE	0.816	0.126	0.819	0.082	0.910
FL	Pi	0.087	0.010	0.093	0.01	0.014
	PCr	0.187	0.015	0.195	0.015	0.051
	γ-ATP	0.103	0.014	0.101	0.011	0.741
	ATP_T	0.307	0.020	0.303	0.016	0.430
	PCr/ATP_T	0.613	0.077	0.645	0.069	0.087
	PCr/γ-ATP	1.869	0.354	1.957	0.303	0.291
	PCr/Pi	2.199	0.363	2.139	0.279	0.468
	PME	0.174	0.017	0.173	0.012	0.789
	PDE	0.185	0.019	0.180	0.016	0.294
	PME/PDE	0.958	0.171	0.971	0.099	0.709

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[TFN1] AIBG: anterior insula-basal ganglia regions; PIBG: posterior insula-basal ganglia regions; FL: frontal lobes. γ-ATP: gamma adenosine triphosphate; Pi: inorganic phosphate; PCr: phosphocreatine; PDE: phosphodiesthers-; PME: phosphomonoesthers-; ATP_t: total adenosine triphosphate; SD: standard deviation; p-value obtained with student’s t-test.