Proton magnetic resonance spectroscopy in children with delayed mental and speech development associated with focal temporal lobe epilepsy

Abstract

Background. The delays in mental and speech development are caused by epilepsy, and a special place among the forms of which is focal temporal epilepsy. The study of biomarkers of the considered pathological condition using proton magnetic resonance spectroscopy as indicators amenable to objective assessment and measurement determines the practical relevance of this work.
 Aim. The aim of the study was to determine the role and place of proton magnetic resonance spectroscopy in clinical practice in children with mental and speech retardation associated with temporal lobe epilepsy.
 Materials and methods. 37 children aged 2 to 10 years were studied. Of these, 15 children with a diagnosis of mental and speech development delay, structural focal temporal epilepsy were included in the first comparison group. The second comparison group consisted of 12 children without CNS pathology undergoing 1H-MRI examination to exclude somatic diseases. The third comparison group consisted of 10 children with structural focal temporal epilepsy, without mental and speech development delay.
 Discussion. Multivoxel proton magnetic resonance spectroscopy (method PRESS) was used to determine the concentration of neurometabolites in the brain tissues of patients. In patients with mental and speech development delay associated with temporal epilepsy, a decrease in the ratio of NAA/Cr concentrations (p 0.05) was revealed in the postcentral gyrus on the right, temporal lobe on the right and hippocampus and inner capsule on both sides, due to a decrease in the concentration of N-acetylaspartate; an increase in the ratio of Cho/Cr concentrations (p 0.05) in the prefrontal cortex, postcentral gyrus and inner capsule on both sides, due to an increase in the concentration of choline. Two patients also showed lipid peaks on the lesion side when compared with EEG data.
 Conclusions. The revealed metabolic changes in patients with delayed mental and speech development associated with temporal lobe epilepsy may be useful as an additional method of differential diagnosis with other forms of mental and speech development delay.