TY - JOUR
T1 - Postoperative changes in cerebral metabolism in temporal lobe epilepsy
AU - Spanaki, Marianna V.
AU - Kopylev, Leonid
AU - DeCarli, Charles
AU - Gaillard, William D.
AU - Liow, Kore
AU - Fazilat, Sharam
AU - Fazilat, Shahin
AU - Reeves, Pat
AU - Sato, Susumu
AU - Kufta, Conrad
AU - Theodore, William H.
PY - 2000
Y1 - 2000
N2 - Background: Fludeoxyglucose F 18 positron emission tomography (18F-FDG-PET) can detect focal metabolic abnormalities ipsilateral to the seizure focus in 80% of patients with temporal lobe epilepsy (TLE). Regions outside the epileptogenic zone can also be affected. We hypothesized that these remote regions might show altered metabolism, tending to return toward normal values, after surgery. Design: Interictal preoperative and postoperative 18F-FDG-PET metabolism were compared in patients with refractory TLE. Based on pathological findings, disease was classified in the following 3 groups: mesial temporal sclerosis, mass lesions, and no pathological diagnosis. Quantitative PET data analysis was performed using the region-of-interest template previously described. Global normalization was used to adjust for the effect of antiepileptic medication changes. Data were analyzed by Wilcoxon signed rank test and analysis of variance. Setting: The Clinical Epilepsy Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health. Patients: Twenty-two patients with refractory TLE. Results: Preoperatively, in all groups, cerebral metabolic rate for glucose was decreased ipsilateral to the resection site in inferior lateral temporal, inferior mesial temporal, and inferior frontal areas and thalamus. Postoperatively, in all groups, cerebral metabolic rate for glucose increased in ipsilateral inferior frontal area and thalamus. In the mesial temporal sclerosis group, we found a statistically significant increase in the contralateral thalamus. Conclusion: Temporal lobe epilepsy is associated with extensive preoperative decreased metabolism in inferior lateral temporal, inferior mesial temporal, and inferior frontal areas and thalamus. Postoperatively, we found increased IF and thalamic metabolism. Seizures may have a reversible effect on brain areas connected with, but remote from, the epileptogenic cortex.
AB - Background: Fludeoxyglucose F 18 positron emission tomography (18F-FDG-PET) can detect focal metabolic abnormalities ipsilateral to the seizure focus in 80% of patients with temporal lobe epilepsy (TLE). Regions outside the epileptogenic zone can also be affected. We hypothesized that these remote regions might show altered metabolism, tending to return toward normal values, after surgery. Design: Interictal preoperative and postoperative 18F-FDG-PET metabolism were compared in patients with refractory TLE. Based on pathological findings, disease was classified in the following 3 groups: mesial temporal sclerosis, mass lesions, and no pathological diagnosis. Quantitative PET data analysis was performed using the region-of-interest template previously described. Global normalization was used to adjust for the effect of antiepileptic medication changes. Data were analyzed by Wilcoxon signed rank test and analysis of variance. Setting: The Clinical Epilepsy Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health. Patients: Twenty-two patients with refractory TLE. Results: Preoperatively, in all groups, cerebral metabolic rate for glucose was decreased ipsilateral to the resection site in inferior lateral temporal, inferior mesial temporal, and inferior frontal areas and thalamus. Postoperatively, in all groups, cerebral metabolic rate for glucose increased in ipsilateral inferior frontal area and thalamus. In the mesial temporal sclerosis group, we found a statistically significant increase in the contralateral thalamus. Conclusion: Temporal lobe epilepsy is associated with extensive preoperative decreased metabolism in inferior lateral temporal, inferior mesial temporal, and inferior frontal areas and thalamus. Postoperatively, we found increased IF and thalamic metabolism. Seizures may have a reversible effect on brain areas connected with, but remote from, the epileptogenic cortex.
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M3 - Article
C2 - 11030796
AN - SCOPUS:0033771994
VL - 57
SP - 1447
EP - 1452
JO - Archives of Neurology
JF - Archives of Neurology
SN - 0003-9942
IS - 10
ER -