GABA+ and Glutamate Metabolites Correlates with Clinical Semeiology of Lateralization in Unilateral Temporal Lobe Epilepsy: MEGA-PRESS Study.

Motivation: TLE is a common epileptic syndrome. Potential dysregulation in GABAergic and glutamatergic mechanisms in epilepsy include neuronal, glial, and/or neuronal-glial interaction dysfunction, leading to increased seizure risks. Goal(s): The study aimed to explore the utility of MEGA-PRESS MRS in patients with drug-resistant temporal lobe epilepsy for seizure lateralization. Approach: In-vivo MRS to assess GABA and Glu levels and video-EEG in drug-resistant unilateral TLE patients for seizure localization. Results: Concordance between neurometabolites with video-EEG for lateralization demonstrates that the correct classification percentage for GABA was 86.7%, indicating an 86.7% chance that GABA will be able to lateralize the unaffected side as detected by VEEG. Impact: Clinical utility of MEGA-PRES as a presurgical tool for assessing in-vivo neurometabolic profiles and adding knowledge of the role of GABA and Glu in epilepsy and its interplay