Metabolic changes in the brain in children with cognitive epileptiform disintegration revealed by proton magnetic resonance spectroscopy

Introduction. Cognitive epileptiform disintegration is a complex of disorders of higher mental functions in a person with a pathological EEG pattern characteristic of epilepsy. In this case, the patient should not have epileptic seizures or a history of single seizures is allowed. The study of biomarkers of the pathological condition under consideration using proton magnetic resonance spectroscopy as indicators that can be objectively evaluated and measured determines the practical relevance of this work.

The aim of the study was to determine the diagnostic significance of the metabolites of N-acetylaspartate, choline and creatine according to proton magnetic resonance spectroscopy in the brain of children with cognitive epileptiform disintegration. 

Material and methods. Using routine MRI and proton magnetic resonance spectroscopy, 6 children with a diagnosis of mental retardation, cognitive epileptiform disintegration at the age of 2 to 7 years (5 boys; 1 girl) were examined. The patients underwent EEG followed by identification of a typical QED pattern. All children had no history of seizures characteristic of epilepsy. Results. А decrease in the ratio of the concentration of NAA/Cr (p<0,05) in the temporal lobes on both sides and the hippocampus on the right was revealed, due to a decrease in the concentration of N-acetylaspartate. There is also an increase in the Cho/NAA concentration ratio (p<0,05) in the hippocampus on the right, and an increase in the Cho/Cr concentration ratio (p<0,05) in the prefrontal cortex, postcentral gyri on both sides, the temporal lobe on the right and the region of the inner capsule on the left, by increasing the concentration of choline. 

Conclusions. Тhe obtained data suggest that changes in neurometabolism in the cholinergic system in children with cognitive epileptiform disintegration are possibly caused by damage to neuronal connections, mainly in the hippocampus and temporal lobes.

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