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- W2800694887 abstract "<h3>BACKGROUND AND PURPOSE:</h3> The ketogenic diet, including both classic and modified forms, is an alternative to antiepileptic medications used in the treatment of drug-resistant epilepsy. We sought to evaluate the utility of proton MR spectroscopy for the detection of β-hydroxybutyrate in a cohort of children with epilepsy treated with the ketogenic diet and to correlate brain parenchymal metabolite ratios obtained from spectroscopy with β-hydroxybutyrate serum concentrations. <h3>MATERIALS AND METHODS:</h3> Twenty-three spectroscopic datasets acquired at a TE of 288 ms in children on the ketogenic diet were analyzed with LCModel using a modified basis set that included a simulated β-hydroxybutyrate resonance. Brain parenchymal metabolite ratios were calculated. Metabolite ratios were compared with serum β-hydroxybutyrate concentrations, and partial correlation coefficients were calculated using patient age as a covariate. <h3>RESULTS:</h3> β-hydroxybutyrate blood levels were highly correlated to brain β-hydroxybutyrate levels, referenced as either choline, creatine, or <i>N</i>-acetylaspartate. They were inversely but more weakly associated with <i>N</i>-acetylaspartate, regardless of the ratio denominator. No strong concordance with lactate was demonstrated. <h3>CONCLUSIONS:</h3> Clinical MR spectroscopy in pediatric patients on the ketogenic diet demonstrated measurable β-hydroxybutyrate, with a strong correlation to β-hydroxybutyrate blood levels. These findings may serve as an effective tool for noninvasive monitoring of ketosis in this population. An inverse correlation between serum β-hydroxybutyrate levels and brain tissue <i>N</i>-acetylaspartate suggests that altered amino acid handling contributes to the antiepileptogenic effect of the ketogenic diet." @default.
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- W2800694887 date "2018-05-03" @default.
- W2800694887 modified "2023-10-16" @default.
- W2800694887 title "β-Hydroxybutyrate Detection with Proton MR Spectroscopy in Children with Drug-Resistant Epilepsy on the Ketogenic Diet" @default.
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- W2800694887 doi "https://doi.org/10.3174/ajnr.a5648" @default.
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