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Hippocampal region asymmetry assessed by 1H-MRS in rolandic epilepsy
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. (Barnneurologisk forskning/Ahlsten)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Oncology, Radiology and Clinical Immunology.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Oncology, Radiology and Clinical Immunology. (RAD)
2003 (English)In: Epilepsia, ISSN 0013-9580, E-ISSN 1528-1167, Vol. 44, no 2, 205-210 p.Article in journal (Refereed) Published
Abstract [en]

PURPOSE: In a previous study, we reported hippocampal abnormalities on magnetic resonance imaging (MRI) in six of 18 children with rolandic epilepsy (RE). In this study, metabolic changes were analyzed in the hippocampal region with proton magnetic resonance spectroscopy (1H-MRS). METHODS: In 13 children with electroclinically typical RE and 15 healthy controls, 1H-MRS results of both hippocampal regions were analyzed. The voxels, 2 x 2 x 4-cm each, were placed to include the head and body of the hippocampus. A PRESS sequence with TR 2,000 ms and TE 32 ms was used. Total N-acetylaspartate (tNAA), glutamine and glutamate (Glx), and choline compounds (tCho) were related to total creatine (tCr), and asymmetry indices (AIs) were calculated. MRI was performed in all 13 patients and in 13 controls. RESULTS: The tNAA/tCr AI of the hippocampal region was significantly higher in children with RE than in control children (z = 4.49; p < 0.001). The AIs of Glx/tCr and tCho/tCr did not show a significant difference between the groups. Lateralization of the interictal epileptiform activity corresponded with the lower tNAA/tCr ratio in 10 of 13 patients. MRI revealed a hippocampal asymmetry in four of 13 in the RE group, three of them showed concordance between the lateralization of the lower tNAA/tCr ratio and the smaller hippocampus. In the control group, a subtle asymmetry in four of 13 children was found. CONCLUSIONS: A significant asymmetry of the hippocampal regions, measured by tNAA/tCr ratios, indicates an abnormal neuronal function in children with RE.

Place, publisher, year, edition, pages
2003. Vol. 44, no 2, 205-210 p.
Keyword [en]
Rolandic epilepsy, Idiopathic focal childhood epilepsy, 1H-MRS, Hippocampus, magnetic resonance spectroscopy
National Category
Medical and Health Sciences
Research subject
Radiology
Identifiers
URN: urn:nbn:se:uu:diva-91502DOI: 10.1046/j.1528-1157.2003.26802.xPubMedID: 12558575OAI: oai:DiVA.org:uu-91502DiVA: diva2:164262
Available from: 2004-03-29 Created: 2004-03-29 Last updated: 2017-12-14Bibliographically approved
In thesis
1. Rolandic Epilepsy: A Neuroradiological, Neuropsychological and Oromotor Study
Open this publication in new window or tab >>Rolandic Epilepsy: A Neuroradiological, Neuropsychological and Oromotor Study
2004 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Rolandic epilepsy (RE) is the most common focal epilepsy syndrome in the pediatric age group with an onset between 3 and 13 years. The syndrome is defined by electro-clinically typical features and has been considered benign according to seizure remission before the age of 16 years.

The aim of this thesis was to investigate children with typical RE with different methods and to discuss the delineation of the syndrome. Thirty-eight children, aged 6–14 years, participated in one up to four studies.

Eighteen children were investigated with MRI. Hippocampal abnormalities were found in six (33%), volume asymmetry in five (28%) and high signal intensities on T2-weighted images in three (17%). Additionally, high signal intensities in T2-weighted images were revealed subcortically in temporal and frontal lobes bilaterally in five children (28%).

The hippocampal region was evaluated metabolically using proton magnetic resonance spectroscopy (1H-MRS) in 13 children with RE and 15 matched controls. A metabolic asymmetry of the hippocampal regions was found in the patients compared to controls indicating an abnormal neuronal function.

Seventeen children with RE and 17 matched controls were investigated with a neuropsychological test battery. The RE children showed lower performance in auditory-verbal tests and in executive functions compared to controls.

Twenty RE children and 24 controls were assessed concerning their oromotor function. The RE children had greater problems concerning tongue movements including articulation. A dichotic listening test was also performed in a subgroup showing poorer results in the RE group.

A simple classification is proposed with RE ‘pure’ as the main group and the frame for this study.

In conclusion, these investigations disclosed various abnormalities in children with RE, challenging the benign concept during the active phase. It is assumed that maturational factors comprise causal mechanism to the deviant findings, which probably successively will normalize.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2004. 80 p.
Series
Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 0282-7476 ; 1332
Keyword
Pediatrics, rolandic epilepsy, children, idiopathic focal epilepsy, magnetic resonance imaging, proton magnetic resonance spectroscopy, cognition, neuropsychology, oromotor performance, dichotic listening, hippocampus, classification, Pediatrik
National Category
Pediatrics
Identifiers
urn:nbn:se:uu:diva-4133 (URN)91-554-5910-2 (ISBN)
Public defence
2004-04-22, Rosénsalen, Barnsjukhuset, Uppsala, 13:15
Opponent
Supervisors
Available from: 2004-03-29 Created: 2004-03-29Bibliographically approved

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