Magnetic Resonance Spectroscopy as applied to epilepsy

p.003 Statement of involvement p.007 Acknowledgements p.008 List of Tables p.009 List of Figures p.010 Published articles and presentations p.012 Main Index p.015 List of Abbreviations p.020 Introduction and Background p.024 Methods p.125 Results p.143 3.1 p.144 3.2 p.168 3.3 p.188 3.4 p.205 3.5 p.224 3.6 p.234 3.7 p.252 Thesis Conclusions and Further Work p.267 Bibliography p.273 P a g e | 3 ABSTRACT Epilepsy is the most common serious disease of the brain. Magnetic Resonance Spectroscopy (MRS) is a novel imaging technique that offers the opportunity for colocalising biochemical information relating to metabolites specific to the study of epilepsy with high resolution MRI. Aims: The work included in this thesis was undertaken with two fundamental aims. The first was to apply a standardised MRS methodology in order to gain reproducible semiquantitative information about the variation of relevant neuro-metabolites such as gamma amino butyric acid (GABA), glutamate (as glutamate plus glutamine [GLX]), N acetyl aspartate (NAA), myo-inositol (Ins) and creatine plus phosphocreatine (Cr) within epilepsy syndromes or pathological groups. The second main aim was to test a series of hypotheses relating to the regulation of the concentrations of these metabolites in the region of epileptic seizures, immediately following seizures and associated with particular medical and surgical treatment interventions.