ArticleActa neurochirurgica2022
Quantitative measurement of peritumoral concentrations of glutamate, N-acetyl aspartate, and lactate on magnetic resonance spectroscopy predicts glioblastoma-related refractory epilepsy.
Article in Acta neurochirurgica, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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16 citing papers in PubMed, 17 citations in OpenAlex.
- Exploring the Role of Advanced MRI in Understanding Glioblastoma Biology: A Scoping Review.Cancers · 2026Review
- 7-T MRSI Mapping of Glutamate and Glutamine in Diffuse Gliomas.Radiology. Imaging cancer · 2025Article
- WONOEP XVII appraisal: Targeting network excitability beyond the synapse -Neurotransmitter, ionic, and electro -diffusions.Epilepsia · 2025Review
- 7T GluCEST in Discriminating Gliomas with Diverse Invasiveness Degrees and Its Association with Invasion Indices.ACS chemical neuroscience · 2025Article
- High-Resolution Mapping of Tumor and Peritumoral Glutamate and Glutamine in Gliomas Using 7-T MRSI.Radiology. Imaging cancer · 2025Article
- Optimized Long-TEJournal of magnetic resonance imaging : JMRI · 2025Article
- Malignant Cells Beyond the Tumor Core: The Non-Negligible Factor to Overcome the Refractory of Glioblastoma.CNS neuroscience & therapeutics · 2025Review
- Three-dimensional amide proton transfer (APT) imaging appliable to navigation surgery can present comparable metabolic activity of glioblastoma toActa neurochirurgica · 2025Article
- Hypoxia-Regulated CD44 and xCT Expression Contributes to Late Postoperative Epilepsy in Glioblastoma.Biomedicines · 2025Article
- Elevated glioma-related cortical glutamateBrain communications · 2025Article
- The complex molecular epileptogenesis landscape of glioblastoma.Cell reports. Medicine · 2024Article
- Glioblastoma disrupts cortical network activity at multiple spatial and temporal scales.Nature communications · 2024Article
- In vivo magnetic resonance spectroscopy for the differential diagnosis of a cerebral mass in a boy with precocious puberty: a case report and review of the literature.Hormones (Athens, Greece) · 2023Review
- Perioperative perampanel administration for early seizure prophylaxis in brain tumor patients.Surgical neurology international · 2023Article
- Glutamate to GABA ratio is elevated in patients with IDH-mutant lower-grade gliomas and seizures.Neuro-oncology advancesArticle
- Role of antiseizure medication in postoperative late seizure and survival among patients with newly diagnosed glioblastoma: A multicenter retrospective study.Neuro-oncology advancesArticle
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16 authors at 4 institutions in 1 country.
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Abstract
backgroundIncreased extracellular glutamate is known to cause epileptic seizures in patients with glioblastoma (GBM). However, predicting whether the seizure will be refractory is difficult. The present study investigated whether evaluation of the levels of various metabolites, including glutamate, can predict the occurrence of refractory seizure in GBM by quantitative measurement of metabolite concentrations on magnetic resonance spectroscopy (MRS).
methodsForty patients were treated according to the same treatment protocol for primary GBM at Ehime University Hospital between April 2017 and July 2021. Of these patients, 23 underwent MRS to determine concentrations of metabolites, including glutamate, N-acetylaspartate, creatine, and lactate, in the tumor periphery by applying LC-Model. The concentration of each metabolite was expressed as a ratio to creatine concentration. Patients were divided into three groups: Type A, patients with no seizures; Type B, patients with seizures that disappeared after treatment; and Type C, patients with seizures that remained unrelieved or appeared after treatment (refractory seizures). Relationships between concentrations of metabolites and seizure types were investigated.
resultsIn 23 GBMs, seizures were confirmed in 11 patients, including Type B in four and Type C in seven. Patients with epilepsy (Type B or C) showed significantly higher glutamate and N-acetylaspartate values than did non-epilepsy patients (Type A) (p < 0.05). No significant differences in glutamate or N-acetylaspartate levels were seen between Types B and C. Conversely, Type C showed significantly higher concentrations of lactate than did Type B (p = 0.001). Cutoff values of lactate-to-creatine, glutamate-to-creatine, and N-acetylaspartate-to-creatine ratios for refractory seizure were > 1.25, > 1.09, and > 0.88, respectively.
conclusionsExtracellular concentrations of glutamate, N-acetylaspartate, and lactate in the tumor periphery were significantly elevated in patients with GBM with refractory seizures. Measurement of these metabolites on MRS may predict refractory epilepsy in such patients and could be an indicator for continuing the use of antiepileptic drugs.
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