AUTHOR=Wu Shuohua , Wang Qianqi , Zhai Huige , Zhang Yiwen , Xu Dongyuan , Yan Gen , Wu Renhua 

TITLE=γ-Aminobutyric acid as a biomarker of the lateralizing and monitoring drug effect in patients with magnetic resonance imaging-negative temporal lobe epilepsy

JOURNAL=Frontiers in Neuroscience

VOLUME=17

YEAR=2023

URL=https://www.frontiersin.org/journals/neuroscience/articles/10.3389/fnins.2023.1184440

DOI=10.3389/fnins.2023.1184440

ISSN=1662-453X

ABSTRACT=<sec><title>Introduction</title><p>Despite verifying proton magnetic resonance spectroscopy (<sup>1</sup>H-MRS) for focal localization in magnetic resonance imaging (MRI)-negative temporal lobe epilepsy (TLE), it is necessary to illustrate metabolic changes and screen for effective biomarkers for monitoring therapeutic effect. We used <sup>1</sup>H-MRS to investigate the role of metabolic levels in MRI-negative TLE.</p></sec><sec><title>Materials and methods</title><p>Thirty-seven patients (<italic>n</italic> = 37, 14 women) and 20 healthy controls (<italic>n</italic> = 20, 11 women) were investigated by <sup>1</sup>H-MRS. We compared the metabolite level changes in the epileptic and contralateral sides on the mesial temporal and dorsolateral prefrontal cortices and analyzed their association with clinical symptoms.</p></sec><sec><title>Results</title><p>γ-Aminobutyric acid (GABA) levels were significantly lower on the epileptic side (2.292 ± 0.890) than in the contralateral side (2.662 ± 0.742, <italic>p</italic> = 0.029*) in patients on the mesial temporal lobe. N-acetylaspartate (NAA) levels were significantly lower on the epileptic side (7.284 ± 1.314) than on the contralateral side (7.655 ± 1.549, <italic>p</italic> = 0.034*). NAA + N-acetylaspartylglutamate levels were significantly lower on the epileptic side (7.668 ± 1.406) than on the contralateral side (8.086 ± 1.675, <italic>p</italic> = 0.032*). Glutamate levels were significantly lower on the epileptic side (7.773 ± 1.428) than on the contralateral side (8.245 ± 1.616, <italic>p</italic> = 0.040*). Moreover, a significant negative correlation was found between GABA levels in the epileptic mesial temporal lobe and tonic–clonic seizure frequency (r = −0.338, <italic>p</italic> = 0.046*).</p></sec><sec><title>Conclusion</title><p>γ-Aminobutyric acid (GABA) is a potential biomarker for lateralization and monitoring seizure frequency in MRI-negative TLE.</p></sec>