Brain glutathione levels in patients with epilepsy measured by in vivo H-1-MRS

Objective: Glutathione in its reduced form (GSH) is the most important free radical scavenging compound in the mammalian nervous system that prevents membrane lipid peroxidation. It is suspected that epileptic seizures are ac companied by a massive production of reactive oxygen species, i.e., oxidati ve stress. Methods: Using an H-1 MRS technique developed at the authors' si te, the authors measured glutathione levels in a volume of interest (VOI) o f 25 X 25 X 25 mm placed in structurally normal-appearing tissue in the par ietooccipital region of each hemispheres in patients with and without activ e epilepsy, and in a age-matched control group. Results: The GSH/water rati o in patients with epilepsy was significantly reduced in the parietooccipit al region of both hemispheres (1.6 +/- 1.0 X 10(-5)) compared to the GSH/wa ter ratio in healthy controls (2.4 +/- 1.1 X 10(-5)). There was no signific ant difference between the hemisphere with epileptogenic focus and the hemi sphere without epileptogenic focus. The GSH/water ratios of the patients wi thout active epilepsy were not different from the GSH/water ratios of patie nts with active epilepsy. Conclusion: The authors found evidence for a wide spread impairment of the glutathione system in patients with epilepsy indep endent from seizure activity.