Brain metabolic differences between temporal lobe epileptic seizures and organic non-epileptic seizures in postictal phase: a retrospective study with magnetic resonance spectroscopy.

Magnetic resonance spectroscopy (MRS) is employed to investigate the brain metabolites differences between patients with temporal lobe epileptic seizures (TLES) and organic non-epileptic seizures (ONES) that appear to be epileptic seizures. Twenty-three patients with TLES and nine patients with ONES in postictal phase underwent MRS examinations on a clinical 1.5T system, with 15 healthy controls in comparison. Statistical analyses on the ratios of brain metabolites were performed using the Mann-Whitney U test with age as a covariate. The results showed that N-acetyl-aspartate/Creatine (NAA/Cr) ratio of patients with TLES was statistically different from that of patients with ONES in postictal phase, i.e., TLES 1.422±0.037, ONES 1.640±0.061, P=0.012 in left temporal pole, while TLES 1.470±0.052, ONES 1.687±0.084, P=0.023 in the right temporal pole. Besides, compared with healthy controls, patients with TLES in postictal phase present significant differences in ratios of NAA/Cr, N-acetyl-aspartate/Choline (NAA/Cho) and NAA/(Cho + Cr). Experimental results demonstrate that NAA/Cr can be used to discriminate TLES from ONES, which has not been found in the references to the best of our knowledge. Although a prospective controlled validation is needed in the future, this retrospective study reveals that MRS may provide useful metabolites information to facilitate the epilepsy diagnosis. 2021 Quantitative Imaging in Medicine and Surgery. All rights reserved.