Background and purpose: This study aims to evaluate the neurochemical characteristics of pathological tissues by ¹H magnetic resonance spectroscopy (MRS) in patient with pharmaco-resistant focal epilepsy at 7 T.

Methods: Thirteen patients with drug-resistant epilepsy and focal seizure successfully underwent MRS examinations at 7 T MRI scanners. ¹H MR spectra were acquired from two voxels (lesion side and contralateral side) using the semi-adiabatic spin-echo full-intensity localized spectroscopy (sSPECIAL) sequence. Metabolite levels were quantified from LCModel and reported as to total creatine ratio.

Results: In comparison to the contralateral side, lesions in focal cortical dysplasia demonstrated significantly reduced macromolecule and N-acetyl aspartate, significantly increased total choline and glycine + myo-inositol, and a distinct reduction trend of glutamate.

Conclusions: We conclude that performing MRS at high magnetic field offered the potential to reveal metabolic alterations in epilepsy lesions that may help to further understand the underlying pathophysiology of the disease.