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Proton MRS evaluation of inflammatory and drug refractoriness biomarkers in temporal lobe epilepsy.

Grant number: 13/21056-4
Support Opportunities:Scholarships in Brazil - Doctorate
Effective date (Start): March 01, 2014
Effective date (End): February 28, 2017
Field of knowledge:Health Sciences - Medicine - Medical Clinics
Principal Investigator:Fernando Cendes
Grantee:Luciana Ramalho Pimentel da Silva
Host Institution: Faculdade de Ciências Médicas (FCM). Universidade Estadual de Campinas (UNICAMP). Campinas , SP, Brazil


Temporal lobe epilepsy (TLE) is the most frequent type of focal epilepsies in adulthood and is often associated to an underlying lesion. Nearly 70% of TLE patients do not achieve seizure control using currently marked antiepileptic drugs (AED). It has been demonstrated both in human resected epileptic tissue and in animal models that epileptogenesis is a multifactorial process related to precipitant insults such as status epilepticus and also inflammatory events might be involved. Several studies using 1H-MRS as a tool have shown a relationship between trauma, viral infections, inflammatory CNS diseases and metabolic alterations, although such a parallel has not been yet demonstrated in human epilepsy. Moreover, glial and inflammatory alterations are possible mechanisms underlying refractoriness in TLE. Thus, our aim will be investigate a possible relationship between metabolic changes on 1H-MRS, inflammatory cytokines biomarkers and refractoriness in TLE. To address this issue, we propose three groups of study: 1 - patients with TLE who did not achieved satisfactory seizure control with the first AED trial (refractory group); 2 - patients who responded to the first AED trial (responsive group); 3 - control subjects (control group). Written informed consent will be taken from all subjects. After a regular T2 axial acquisition to define the region of interest, multivoxel 1H-MRS will be acquired using a PRESS ("Point Resolved Spectroscopy") sequence. Resonance intensities on MRS will be determined from integration of peak areas between frequency bounds using the software LC-Model. Then, the 1H-MRS metabolic profiles will be compared to each cytokine evaluated in the three referred groups.

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Scientific publications
(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)
ZANAO, TAMIRES A.; SEITZ-HOLLAND, JOHANNA; O'DONNELL, LAUREN J.; ZHANG, FAN; RATHI, YOGESH; LOPES, TATILA M.; PIMENTEL-SILVA, LUCIANA RAMALHO; YASSUDA, CLARISSA L.; MAKRIS, NIKOS; SHENTON, MARTHA E.; et al. Exploring the impact of hippocampal sclerosis on white matter tracts memory in individuals with mesial temporal lobe epilepsy. EPILEPSIA OPEN, v. 8, n. 3, p. 12-pg., . (13/21056-4, 16/10433-0, 18/05393-4, 13/07559-3)
PIMENTEL-SILVA, LUCIANA R.; CASSEB, RAPHAEL F.; CORDEIRO, MONICA M.; CAMPOS, BRUNO A. G.; ALVIM, MARINA K. M.; ROGERIO, FABIO; YASUDA, CLARISSA L.; CENDES, FERNANDO. Interactions between in vivo neuronal-glial markers, side of hippocampal sclerosis, and pharmacoresponse in temporal lobe epilepsy. Epilepsia, v. 61, n. 5, . (13/21056-4, 14/15918-6, 13/07559-3)
URQUIA-OSORIO, HEBEL; PIMENTEL-SILVA, LUCIANA R.; REZENDE, THIAGO JUNQUEIRA RIBEIRO; ALMENDARES-BONILLA, EIMY; YASUDA, CLARISSA L.; CONCHA, LUIS; CENDES, FERNANDO. Superficial and deep white matter diffusion abnormalities in focal epilepsies. Epilepsia, v. N/A, p. 13-pg., . (16/05985-3, 13/21056-4, 13/07559-3)
Academic Publications
(References retrieved automatically from State of São Paulo Research Institutions)
SILVA, Luciana Ramalho Pimentel da. Pharmacoresponse, hippocampal sclerosis and inflammation in mesial temporal lobe epilepsy: influence on metabolites measured by proton magnetic resonance spectroscopy. 2018. Doctoral Thesis - Universidade Estadual de Campinas (UNICAMP). Faculdade de Ciências Médicas Campinas, SP.

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