Hubungan Rasio GABA/Glutamate pada Magnetic Resonance Spectroscopy dengan Gambaran Lesi pada Epilepsi
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Epilepsi merupakan gangguan neurologis kronis yang ditandai oleh ketidakseimbangan neurotransmiter eksitatori dan inhibitor, terutama glutamat dan gamma-aminobutyric acid (GABA), yang berperan dalam proses epileptogenesis dan kekambuhan kejang. Pemeriksaan Magnetic Resonance Imaging (MRI) konvensional belum selalu mampu mendeteksi seluruh lesi struktural sehingga diperlukan biomarker tambahan yang dapat menggambarkan perubahan metabolik jaringan otak epileptogenik. Penelitian ini bertujuan menganalisis hubungan antara rasio GABA/glutamat yang diukur menggunakan Magnetic Resonance Spectroscopy (MRS) dengan gambaran lesi pada pasien epilepsi. Penelitian menggunakan desain cross-sectional prospektif terhadap 52 pasien epilepsi yang menjalani pemeriksaan MRS di Instalasi Radiologi RSUD Dr. Moewardi Surakarta dengan teknik consecutive sampling. Analisis data meliputi statistik deskriptif, uji normalitas Shapiro–Wilk, uji Fisher's Exact, serta analisis akurasi diagnostik. Hasil penelitian menunjukkan bahwa 94,2% pasien memiliki rasio GABA/glutamat yang tidak normal, mencerminkan adanya ketidakseimbangan neurokimia yang dominan. Tidak ditemukan hubungan yang bermakna antara rasio GABA/glutamat dengan lokasi lesi (p = 0,660) maupun jenis lesi (p = 0,723). Analisis diagnostik menunjukkan sensitivitas sebesar 95,0%, spesifisitas 10,0%, nilai prediksi positif 81,6%, dan nilai prediksi negatif 33,3%. Disimpulkan bahwa rasio GABA/glutamat lebih merefleksikan aktivitas metabolik epileptogenik dibandingkan karakteristik lesi struktural serta berpotensi menjadi biomarker pelengkap MRI dalam evaluasi klinis pasien epilepsi.
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