Quantifying Interictal Metabolic Activity in Human Temporal Lobe Epilepsy

• Published in: Journal of cerebral blood flow and metabolism 1990-09, Vol.10 (5), p.748-757
• Main Authors: Henry, Thomas R., Mazziotta, John C., Engel, Jerome, Christenson, Peter D., Zhang, Jing Xi, Phelps, Michael E., Kuhl, David E.
• Format: Article
• Language: English
• Subjects: 550901 > Pathology-- Tracer Techniques; ALDEHYDES; BASIC BIOLOGICAL SCIENCES; BETA DECAY RADIOISOTOPES; BETA-PLUS DECAY RADIOISOTOPES; Biological and medical sciences; BODY; BRAIN; Brain - metabolism; CARBOHYDRATES; CENTRAL NERVOUS SYSTEM; COMPUTERIZED TOMOGRAPHY; Deoxyglucose - analogs & derivatives; Deoxyglucose - metabolism; DIAGNOSIS; DIAGNOSTIC TECHNIQUES; DISEASES; EMISSION COMPUTED TOMOGRAPHY; EPILEPSY; Epilepsy, Temporal Lobe - metabolism; FLUORINE 18; FLUORINE ISOTOPES; Fluorine Radioisotopes; Fluorodeoxyglucose F18; GLUCOSE; Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy; HEXOSES; HOURS LIVING RADIOISOTOPES; Humans; ISOMERIC TRANSITION ISOTOPES; ISOTOPES; LIGHT NUCLEI; Medical sciences; METABOLISM; MONOSACCHARIDES; NERVOUS SYSTEM; Nervous system (semeiology, syndromes); NERVOUS SYSTEM DISEASES; Neurology; NUCLEI; ODD-ODD NUCLEI; ORGANIC COMPOUNDS; ORGANS; PATIENTS; POSITRON COMPUTED TOMOGRAPHY; RADIOISOTOPES; RADIOLOGY AND NUCLEAR MEDICINE; SACCHARIDES; TOMOGRAPHY 550601 > Medicine-- Unsealed Radionuclides in Diagnostics; Tomography, Emission-Computed
• ISSN: 0271-678X; 1559-7016
• DOI: 10.1038/jcbfm.1990.128

The majority of patients with complex partial seizures of unilateral temporal lobe origin have interictal temporal hypometabolism on [18F]fluorodeoxyglucose positron emission tomography (FDG PET) studies. Often, this hypometabolism extends to ipsilateral extratemporal sites. The use of accurately quantified metabolic data has been limited by the absence of an equally reliable method of anatomical analysis of PET images. We developed a standardized method for visual placement of anatomically configured regions of interest on FDG PET studies, which is particularly adapted to the widespread, asymmetric, and often severe interictal metabolic alterations of temporal lobe epilepsy. This method was applied by a single investigator, who was blind to the identity of subjects, to 10 normal control and 25 interictal temporal lobe epilepsy studies. All subjects had normal brain anatomical volumes on structural neuroimaging studies. The results demonstrate ipsilateral thalamic and temporal lobe involvement in the interictal hypometabolism of unilateral temporal lobe epilepsy. Ipsilateral frontal, parietal, and basal ganglial metabolism is also reduced, although not as markedly as is temporal and thalamic metabolism.