Theodore W H, Gaillard W D, De Carli C, Bhatia S, Hatta J
Clinical Epilepsy Section, Epilepsy Research Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, 10 Center Drive, Bldg. 10, Room 5N-250, Bethesda, MD 20892-1408, USA.
Epilepsia. 2001 Jan;42(1):130-2. doi: 10.1046/j.1528-1157.2001.080874.x.
Reports conflict on the relation of glucose metabolism to hippocampal volume in temporal lobe foci. Previous studies usually have used side-side ratios rather than regional metabolic rates.
We measured hippocampal volume and glucose metabolism in 37 patients with temporal epileptogenic zones identified by ictal video-EEG telemetry. Metabolic rates were normalized to global brain mean.
Both 18-fluoro-2-deoxyglucose-PET and volumetric MRI lateralized the epileptic focus determined by ictal video-EEG. There were significant correlations between left-right metabolic asymmetry and hippocampal formation volume left-right ratios. Comparisons between normalized metabolism and hippocampal formation volume, ignoring the side of the epileptic focus, showed significant relations between left hippocampal volume and left inferior lateral temporal metabolism, right hippocampus and right inferior mesial temporal, and left hippocampus and left inferior mesial temporal metabolism. In contrast, when normalized metabolism was compared with hippocampal volume in the epileptic focus, no relation was found.
Our study suggests that the relation between hippocampal volume and glucose metabolism breaks down in epileptic foci and that hypometabolism is not dependent on neuronal loss. It is consistent with data suggesting that hypometabolism is an independent predictor of surgical outcome.
关于颞叶病灶中葡萄糖代谢与海马体积之间的关系，报告存在冲突。以往研究通常使用左右比率而非区域代谢率。
我们测量了37例通过发作期视频脑电图遥测确定颞叶致痫区的患者的海马体积和葡萄糖代谢。代谢率以全脑平均值进行标准化。
18氟脱氧葡萄糖PET和容积MRI均将发作期视频脑电图确定的癫痫病灶定位于一侧。左右代谢不对称与海马结构体积左右比率之间存在显著相关性。忽略癫痫病灶的侧别，对标准化代谢与海马结构体积进行比较，结果显示左侧海马体积与左侧颞下回外侧代谢、右侧海马与右侧颞中回内侧、左侧海马与左侧颞中回内侧代谢之间存在显著关系。相比之下，当将癫痫病灶处的标准化代谢与海马体积进行比较时，未发现相关性。
我们的研究表明，癫痫病灶中海马体积与葡萄糖代谢之间的关系被打破，且代谢减低并不依赖于神经元丢失。这与表明代谢减低是手术结果的独立预测因素的数据一致。
