Abstract #3080

GABA+ and Glutamate Metabolites Correlates with Clinical Semeiology of Lateralization in Unilateral Temporal Lobe Epilepsy: MEGA-PRESS Study.

Manoj Kumar¹, Nikhilesh Pradhan², Sandhya Mangalore¹, Pawan Bairwa¹, Raghvendra K², Dinesh Kumar Deelchand³, Vishwanathan LG², Ajay Asranna², Mundlamuri RC², Prathyusha PV⁴, and Sanjib Sinha²

¹Neuroimaging and Interventional Radiology, National Institute of Mental Health and Neurosciences, Bengaluru, India, ²Neuology, National Institute of Mental Health and Neurosciences, Bengaluru, India, ³Radiology, Center for Magnetic Resonance Research (CMRR),, University of Minnesota, Minneapolis, Minneapolis, MN, United States, ⁴Biostatistic, National Institute of Mental Health and Neurosciences, Bengaluru, India

Synopsis

Keywords: Epilepsy, Epilepsy, MRS, Neurometabolites, Neurotransmission

Motivation: TLE is a common epileptic syndrome. Potential dysregulation in GABAergic and glutamatergic mechanisms in epilepsy include neuronal, glial, and/or neuronal-glial interaction dysfunction, leading to increased seizure risks.

Goal(s): The study aimed to explore the utility of MEGA-PRESS MRS in patients with drug-resistant temporal lobe epilepsy for seizure lateralization.

Approach: In-vivo MRS to assess GABA and Glu levels and video-EEG in drug-resistant unilateral TLE patients for seizure localization.

Results: Concordance between neurometabolites with video-EEG for lateralization demonstrates that the correct classification percentage for GABA was 86.7%, indicating an 86.7% chance that GABA will be able to lateralize the unaffected side as detected by VEEG.

Impact: Clinical utility of MEGA-PRES as a presurgical tool for assessing in-vivo neurometabolic profiles and adding knowledge of the role of GABA and Glu in epilepsy and its interplay

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