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PubMed · 10999205

MRS methodology.

Abstract

There are several options in the MRS methods that require consideration before proceeding with the acquisition of the data. The decision to select a nucleus should be based solely on the metabolic information sought. For instance, if an investigator is interested in the effects of medication on the bioenergetic status of the brain, then 31P MRS is indicated. Similarly, selecting the TE for 1H MRS should be based on the metabolite sought. Resonances assigned to myo-In and Glx can only be detected at short TE. Selecting between single-voxel and spectroscopic imaging depends on the requirements of the study. For example, if spatial information is needed, then MRS data ought to be acquired via spectroscopic imaging. However, if the spatial resolution is not critical and interest is to compare a pathologic area with a contralateral VOI, then the acquisition of two single-voxel spectra may be preferred. MRS is widely used. All major vendors of MRI instruments provide some spectroscopic capabilities as a commercially available package with their equipment. Its application to epilepsy has been significant, to which the 40 plus research papers from more than a dozen centers around the world attest.

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BibTeXRIS

I Constantinidis. 2000. MRS methodology.. https://pubmed.ncbi.nlm.nih.gov/10999205/

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Long-term seizure outcomes and factors associated with response to adjunctive everolimus in TSC-associated epilepsy.

BACKGROUND: Everolimus, a mechanistic target of rapamycin (mTOR) inhibitor, is increasingly used in tuberous sclerosis complex (TSC)-associated epilepsy; however, long-term real-world outcomes and factors associated with favorable response remain unclear. This study aimed to evaluate the long-term seizure outcomes of adjunctive everolimus and explore clinical factors associated with treatment response. METHODS: We retrospectively recruited 21 patients with active TSC-associated epilepsy receiving adjunctive everolimus and assessed seizure outcomes during follow-up. Clinical characteristics were compared between responders and non-responders at 1 year after treatment initiation. RESULTS: Over a median treatment duration of 72 months, responder rates ranged from 53.8% to 64.7%, and seizure-free rates ranged from 33.3% to 41.2%. Responders had fewer involved organ systems at baseline (median 3 vs. 4, p = 0.020) and lower anti-seizure medication burden (median 2 vs. 4, p = 0.045). Younger age at treatment initiation showed a trend toward improved response. CONCLUSION: Adjunctive everolimus was associated with sustained long-term seizure reduction in this real-world cohort. In exploratory analyses, fewer involved organ systems and fewer baseline ASMs were associated with favorable treatment response. These findings require validation in larger prospective cohorts.

Epilepsy↗