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.