{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T08:19:07Z","timestamp":1790151547143,"version":"4.0.1"},"reference-count":28,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2017,2,22]],"date-time":"2017-02-22T00:00:00Z","timestamp":1487721600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001700","name":"Ministry of Education, Culture, Sports, Science, and Technology (MEXT) of Japan","doi-asserted-by":"crossref","award":["16H05438"],"award-info":[{"award-number":["16H05438"]}],"id":[{"id":"10.13039\/501100001700","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Epilepsia"],"published-print":{"date-parts":[[2017,4]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Brain hypothermia controls epileptic discharge and reduces extracellular concentrations of glutamate (Glu), an excitatory neurotransmitter. We aimed to determine the effects of focal brain cooling (<jats:styled-content style=\"fixed-case\">FBC<\/jats:styled-content>) on levels of \u03b3\u2010aminobutyric acid (<jats:styled-content style=\"fixed-case\">GABA<\/jats:styled-content>), which is a major inhibitory neurotransmitter. The relationship between Glu or <jats:styled-content style=\"fixed-case\">GABA<\/jats:styled-content> concentrations and the severity of epileptic symptoms was also analyzed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients with intractable epilepsy underwent <jats:styled-content style=\"fixed-case\">FBC<\/jats:styled-content> at lesionectomized (n = 11) or hippocampectomized (n = 8) regions at 15\u00b0C for 30 min using custom\u2010made cooling devices. Concentrations of Glu (n = 18) and <jats:styled-content style=\"fixed-case\">GABA<\/jats:styled-content> (n = 12) were measured in extracellular fluid obtained through microdialysis using high\u2010performance liquid chromatography (HPLC). The reduction rate of neurotransmitter levels and its relationship with electrocorticography (<jats:styled-content style=\"fixed-case\">EC<\/jats:styled-content>oG) signal changes in response to <jats:styled-content style=\"fixed-case\">FBC<\/jats:styled-content> were measured.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We found no relationship between the concentrations of Glu or <jats:styled-content style=\"fixed-case\">GABA<\/jats:styled-content> and seizure severity. There was a significant decrease in the concentration of Glu to 66.3% of control levels during the cooling period (p = 0.001). This rate of reduction correlated with <jats:styled-content style=\"fixed-case\">EC<\/jats:styled-content>oG power (r<jats:sup>2<\/jats:sup> = 0.68). Cortical and hippocampal <jats:styled-content style=\"fixed-case\">GABA<\/jats:styled-content> levels significantly (p = 0.02) and nonsignificantly decreased to 47.7% and 32.4% of control levels, respectively. However, the rate of this reduction did not correlate with <jats:styled-content style=\"fixed-case\">EC<\/jats:styled-content>oG (r<jats:sup>2<\/jats:sup> = 0.11).<\/jats:p><\/jats:sec><jats:sec><jats:title>Significance<\/jats:title><jats:p>Although the decrease in hippocampal <jats:styled-content style=\"fixed-case\">GABA<\/jats:styled-content> levels was not significant due to wide variations in its concentration, the levels of cortical <jats:styled-content style=\"fixed-case\">GABA<\/jats:styled-content> and Glu were decreased following <jats:styled-content style=\"fixed-case\">FBC<\/jats:styled-content>. <jats:styled-content style=\"fixed-case\">FBC<\/jats:styled-content> suppresses epileptic discharge and the release of both excitatory and inhibitory neurotransmitters. The reduction in Glu levels further contributes to the reduction in epileptic discharge. However, the reduction in the levels of <jats:styled-content style=\"fixed-case\">GABA<\/jats:styled-content> has no impact on <jats:styled-content style=\"fixed-case\">EC<\/jats:styled-content>oG.<\/jats:p><\/jats:sec>","DOI":"10.1111\/epi.13704","type":"journal-article","created":{"date-parts":[[2017,2,22]],"date-time":"2017-02-22T11:42:46Z","timestamp":1487763766000},"page":"627-634","source":"Crossref","is-referenced-by-count":22,"title":["Effects of focal brain cooling on extracellular concentrations of neurotransmitters in patients with epilepsy"],"prefix":"10.1111","volume":"58","author":[{"given":"Sadahiro","family":"Nomura","sequence":"first","affiliation":[{"name":"Department of Neurosurgery Yamaguchi University School of Medicine Ube Japan"},{"name":"Epilepsy Center Yamaguchi University Hospital Ube Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takao","family":"Inoue","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Yamaguchi University School of Medicine Ube Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hirochika","family":"Imoto","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Yamaguchi University School of Medicine Ube Japan"},{"name":"Epilepsy Center Yamaguchi University Hospital Ube Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eiichi","family":"Suehiro","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Yamaguchi University School of Medicine Ube Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuichi","family":"Maruta","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Yamaguchi University School of Medicine Ube Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuya","family":"Hirayama","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Yamaguchi University School of Medicine Ube 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