A Study Of ~1H-magnetic Resonance Spectroscopy On Bilateral Thalamus Of Patients With Complex Partial And Secondarily Generalized Seizures

Objective: Through 1H-MRS quantitative analy the bilateral thalamus metabolites ratio of CPS and CGS, to observe CPS and whether GTCS effects on thalamus mechanism. to explor e the role of the halamus in the mechanism of CPS.Methods: According to the Chinese medical association compile《The clinical guidelines, epilepsy fascicle 》 the diagnostic criteria in 2007 and International league against epilepsy(ILAE) published international classification criteria of epilepsy seizures released in 1981.Selection from March 2014 to March 2015 in Dalian Medical University First Affiliated Hospital outpatient and the inpatient diagnosis of complex partial seizure( CPS) and complex part of the secondary comprehensive attack(CGC) of people with epilepsy, into the group ranging in age from 18 to 50 years old, a total of 24 cases in epileptic patients, among which 14 of patients with the CPS, 10 of patients with the CGS, and included in the 18 of normal controls. The head of the 1.5 T MRI scan of all the research objects are abnormal, by use hydrogen proton magnetic resonance spectrum technique to detect n-acetyl aspartate(NAA), choline compounds(Cho), creatine and creatine phosphate(Cr- PCr) metabolites of all the research objects of bilateral thalamus. All data are analyzed by SPSS19.0 statistics software, with p < 0.05 for statistically difference.Results: For all patients with thalamic metabolites inspection found that the metabolite ratio of the left and the right thalamus has no obvious difference, gender, age are not effect on the thalamus metabolites ratio. NAA/(Cr- PCr+ Cho), NAA/Cr- PCr, Cho/Cr- PCr average ratio of the thalamus of normal control group on the left side were 0.90 ± 0.03, 1.82 ± 0.05, 1.23 ±0.04; Right: 0.90 ± 0.03, 1.72 ± 0.06, 1.14± 0.04; that on the left side of the thalamus of CPS were 0.74 ±0.04, 1.57 ±0.05, 1.22± 0.07; Right: 0.71 ±0.02, 1.54 ± 0.05, 1.18±0.04; that on the left side of the thalamus of CGS were 0.78 ±0.03, 1.50 ± 0.07, 1.46± 0.05; Right: 0.67± 0.03, 1.42± 0.05 and 0.05 ± 0.06. The CPS group compared with normal control group the thalamus NAA/(Cr-PCr+ Cho), NAA/Cr-PCr were lower, both < 0.05, the difference is statistically significant; Cho/Cr- PCr, the right side of the p is 0.44, the left side of the p is 0.89, p > 0.05, there was no statistically significant difference. CGS group compared with normal control group that NAA/(Cr-PCr+ Cho), NAA/Cr-PCr were lower, Cho/Cr-PCr were riser, both p < 0.05, the difference is statistically significant. CPS group compare with the CGS that NAA/(Cr-PCr+ Cho), the NAA/Cr-PCr is higher, respective p were 0.22, 0.10 on the right side of the thalamus, that respective p value were 0.54, 0.54 on left thalamus, p values > 0.05, there was no statistically significant difference; CPS group compare with CGS group to reduce Cho/Cr- PCr: respective p value is 0.039 on the right side of the thalamus, the left thalamus p is 0.02, p < 0.05, the difference is statistically significant. In the CPS group and CGS group analye process and frequency to find them had no statistically significant effect on the metabolism ratio.(p > 0.05).Conclusion: 1、1 H- MRS can find cerebral metabolic abnormalities of MRI negative patients;2、NAA/Cr-PCr, NAA/(Cr-PCr+Cho) of the bilateral thalamus of CPS and CGS patients compared with normal patients are lower, reflecting the neurons metabolic abnormalities; 3、Cho/Cr-PCr,of CGS patients is higher than which of CPS reflect glial cell proliferation.