Longitudinal study of MRS metabolites in Rasmussens encephalitis

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Title Longitudinal study of MRS metabolites in Rasmussens encephalitis
Author Wellard, R. M.; Briellmann, R.S.; Wilson, Jenny; Kalnins, R.M.; Anderson, D.P.; Sederico, P.; Fabinyi, D.C.A.; Scheffer, I.E.; Harvey, A.S.; Jackson, D.G.
Journal Name Brain
Year Published 2004
Place of publication Oxford
Publisher Oxford University Press
Abstract This study analyses the evolution of metabolite changes in an 8-year-old boy with focal Rasmussen encephalitis. Five MRI examinations, including magnetic resonance spectroscopy (MRS) were performed over 9 months. Following complex partial status, T2-weighted imaging showed transient dramatic signal increase in the left superior temporal gyrus and mesial temporal structures. Subsequent scans showed resolution of the swelling and signal normalization, with development of slight focal atrophy. MRS after status showed a reduction in N-acetylaspartate, total creatine and trimethylamines. Subsequent scans showed complete resolution of these metabolite abnormalities, followed later by development of further abnormal metabolite values. Lactate and glutamine/glutamate were elevated after status. After surgery, ex vivo high-field 1H and 31P MRS confirmed metabolite abnormalities (elevated choline and decreased aspartate, N-acetylaspartate, [1H]glutamate together with altered [31P]phospholipid ratios. These findings suggested active disease process in the anterior region of the excised superior temporal gyrus. We conclude that Rasmussen encephalitis is a combination of progressive encephalitic damage and fluctuating seizure effects, in which neuronal injury and recovery can occur. MRS measurements at a single time point should consider the fluctuating metabolite profile related to seizure activity.
Peer Reviewed Yes
Published Yes
Publisher URI http://brain.oxfordjournals.org/
Alternative URI http://dx.doi.org/10.1093/brain/awh157
Copyright Statement This is a pre-copy-editing, author-produced PDF of an article accepted for publication in Brain following peer review. The definitive publisher-authenticated version Brain (2004), 127, 1302-1312 is available online at: http://dx.doi.org/10.1093/brain/awh157
Volume 127
Issue Number 6
Page from 1302
Page to 1312
ISSN 0006-8950
Date Accessioned 2005-03-23
Language en_US
Research Centre Institute for Glycomics
Faculty Institute for Glycomics
Subject PRE2009-Biological and Medical Chemistry
URI http://hdl.handle.net/10072/5063
Publication Type Journal Articles (Refereed Article)
Publication Type Code c1

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