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To explore the possible metabolic alterations of bilateral dorsolateral prefrontal cortices (DLPFC) of generalized tonic-clonic seizures (GTCS) patients before and after antiepileptic drugs treatment as compared with healthy controls (HCs) using proton magnetic resonance spectroscopy (1H-MRS). We included 23 newly diagnosed and unmedicated GTCS patients and 23 sex- and age-matched HCs. Metabolites including N-acetyl aspartate (NAA), myo-inositol (Ins), choline (Cho), creatine (Cr), and glutamate + glutamine (Glu + Gln, Glx) concentrations were quantified by using LCModel software and then corrected for the partial volume effect of cerebrospinal fluid. The results demonstrated that metabolite concentrations were not equal between the left and the right DLPFC. Compared with HC, NAA of the left DLPFC and Cr of the right DLPFC were significantly lower in pre-treatment patients. Self-controlled study revealed that the patients' NAA of the left DLPFC increased while their Cr of the right DLPFC decreased after treatment. Correlation analysis showed a negative correlation between the duration of medication and the pre- and post-treatment difference of Cr. These findings may shed a light on the metabolic mechanism of GTCS and the neurobiochemical mechanisms of AEDs. © 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.


Xinyue Wan, Ling Liu, Weina Wang, Qiaoyue Tan, Xiaorui Su, Simin Zhang, Xibiao Yang, Qiang Yue, Qiyong Gong. 1H-MRS reveals metabolic alterations in generalized tonic-clonic seizures before and after treatment. Acta neurologica Scandinavica. 2022 Feb;145(2):200-207

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PMID: 34595746

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