Changes in glutamate concentration, glucose metabolism, and cerebral blood flow during focal brain cooling of the epileptogenic cortex in humans

Sadahiro Nomura, Masami Fujii, Takao Inoue, Yeting He, Yuichi Maruta, Hiroyasu Koizumi, Eiichi Suehiro, Hirochika Imoto, Hideyuki Ishihara, Fumiaki Oka, Mishiya Matsumoto, Yuji Owada, Takeshi Yamakawa, Michiyasu Suzuki

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14 Citations (Scopus)

Abstract

Objective Recently, focal brain cooling (FBC) was proposed as a method for treating refractory epilepsy. However, the precise influence of cooling on the molecular basis of epilepsy has not been elucidated. Thus the aim of this study was to assess the effect of FBC on glutamate (Glu) concentration, cerebral blood flow (CBF), and glucose metabolism in patients with intractable epilepsy. Methods Nine patients underwent FBC at 15C for 30 min prior to cortical resection (n = 6) or hippocampectomy (n = 3). Measurement of metabolites and CBF, as well as electrocorticography (ECoG), was performed. Results Epileptic discharge (ED), as observed by ECoG, disappeared in the cooling period and reappeared in the rewarming period. Glu concentrations were high during the precooling period and were reduced to 51.2% during the cooling period (p = 0.025). Glycerol levels showed a similar decrease (p = 0.028). Lactate concentration was high during the precooling period and was reduced during the cooling period (21.3% decrease; p = 0.005). Glucose and pyruvate levels were maintained throughout the procedure. Changes in CBF were parallel to those observed by ECoG. Significance FBC reduced EDs and concentrations of Glu and glycerol. This demonstrates the neuroprotective effect of FBC. Our findings confirm that FBC is a reasonable and optimal treatment option for patients with intractable epilepsy.

Original languageEnglish
Pages (from-to)770-776
Number of pages7
JournalEpilepsia
Volume55
Issue number5
DOIs
Publication statusPublished - 2014 May
Externally publishedYes

Keywords

  • Cerebral blood flow
  • Epilepsy
  • Glutamate
  • Hypothermia
  • Lactate

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

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  • Cite this

    Nomura, S., Fujii, M., Inoue, T., He, Y., Maruta, Y., Koizumi, H., Suehiro, E., Imoto, H., Ishihara, H., Oka, F., Matsumoto, M., Owada, Y., Yamakawa, T., & Suzuki, M. (2014). Changes in glutamate concentration, glucose metabolism, and cerebral blood flow during focal brain cooling of the epileptogenic cortex in humans. Epilepsia, 55(5), 770-776. https://doi.org/10.1111/epi.12600