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Excitatory-inhibitory imbalance in temporal lobe epilepsy: a 5T multimodal MRI biomarker for focus localization and drug resistance stratification
Excitatory-inhibitory imbalance in temporal lobe epilepsy: a 5T multimodal MRI biomarker for focus localization and drug resistance stratification
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Excitatory-inhibitory imbalance in temporal lobe epilepsy: a 5T multimodal MRI biomarker for focus localization and drug resistance stratification
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Excitatory-inhibitory imbalance in temporal lobe epilepsy: a 5T multimodal MRI biomarker for focus localization and drug resistance stratification
Excitatory-inhibitory imbalance in temporal lobe epilepsy: a 5T multimodal MRI biomarker for focus localization and drug resistance stratification

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Excitatory-inhibitory imbalance in temporal lobe epilepsy: a 5T multimodal MRI biomarker for focus localization and drug resistance stratification
Excitatory-inhibitory imbalance in temporal lobe epilepsy: a 5T multimodal MRI biomarker for focus localization and drug resistance stratification
Journal Article

Excitatory-inhibitory imbalance in temporal lobe epilepsy: a 5T multimodal MRI biomarker for focus localization and drug resistance stratification

2025
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Overview
This study aimed to investigate the diagnostic value of combined glutamate chemical exchange saturation transfer (GluCEST) imaging and γ-aminobutyric acid (GABA)-edited proton magnetic resonance spectroscopy ( 1 H-MRS) in localizing epileptogenic foci and differentiating drug-resistant epilepsy (DR) from drug-responsive epilepsy (DRES) in temporal lobe epilepsy (TLE) using 5T MRI. Twenty-four TLE patients (13 left, 11 right) and 25 age-/gender-matched healthy controls (HCs) underwent GluCEST and MEGA-PRESS MRS at 5T MRI. Directional asymmetry indices (DAIglu_H for hippocampus, DAIglu_A for amygdala) and a novel composite biomarker (DAIglu_GABA) integrating GluCEST asymmetry and GABA/Cr ratios were analyzed. Another asymmetry metric was employed to discriminate the left and right TLE groups [DAIglu_H(epi) for hippocampus, DAIglu_A(epi) for amygdala]. Subgroup comparisons (HC vs. DR vs. DRES) and receiver-operating characteristic (ROC) analyses were performed.