Theodore William H, Giovacchini Giampiero, Bonwetsch Robert, Bagic Anto, Reeves-Tyer Patricia, Herscovitch Peter, Carson Richard E
Clinical Epilepsy Section, National Institute of Neurological Diseases and Strokes, Bethesda, Maryland, USA.
Epilepsia. 2006 Mar;47(3):499-503. doi: 10.1111/j.1528-1167.2006.00458.x.
To study the effect of antiepileptic drugs (AEDs) on 5-HT(1A)-receptor binding in patients with temporal lobe epilepsy. 5-HT(1A)-receptor binding, measured by positron emission tomography, is reduced in patients with temporal lobe epilepsy. Antiepileptic drugs may act on the serotonergic system, as shown in animal models, and thus affect receptor-binding measurements.
We analyzed the effect of AEDs on 5-HT(1A)-receptor binding in 31 patients and 10 normal controls. Patients with structural lesions, progressive neurologic disorders, or taking other medications were excluded. None had a seizure for >or=2 days before positron emission tomography (PET). [(18)F]FCWAY PET was performed on a GE Advance scanner with continuous EEG monitoring. Functional images of the distribution volume (V) were generated. Anatomic regions of interest were applied to co-registered PET images, after correction for partial-volume effect.
Patients had significantly higher [(18)F]FCWAY free fraction (f(1)) than did controls. No AED effects were observed on interictal [(18)F]FCWAY binding after correction for plasma free fraction. [(18)F]FCWAY V/f1 reduction in epileptic foci was not affected by AEDs.
5-HT(1A)-receptor binding is reduced in temporal lobe epileptic foci after partial-volume correction. AED plasma free fractions should be measured when PET receptor studies are performed in patients with epilepsy.
研究抗癫痫药物（AEDs）对颞叶癫痫患者5-HT(1A)受体结合的影响。通过正电子发射断层扫描测量发现，颞叶癫痫患者的5-HT(1A)受体结合减少。如动物模型所示，抗癫痫药物可能作用于血清素能系统，从而影响受体结合测量。
我们分析了AEDs对31例患者和10名正常对照者5-HT(1A)受体结合的影响。排除有结构性病变、进行性神经疾病或正在服用其他药物的患者。在进行正电子发射断层扫描（PET）前，无一例患者癫痫发作≥2天。在GE Advance扫描仪上进行[(18)F]FCWAY PET检查，并持续监测脑电图。生成分布容积（V）的功能图像。在校正部分容积效应后，将感兴趣的解剖区域应用于配准的PET图像。
患者的[(18)F]FCWAY游离分数（f(1)）显著高于对照组。在校正血浆游离分数后，未观察到AEDs对发作间期[(18)F]FCWAY结合的影响。癫痫病灶中[(18)F]FCWAY V/f1的降低不受AEDs影响。
校正部分容积后，颞叶癫痫病灶中的5-HT(1A)受体结合减少。在对癫痫患者进行PET受体研究时，应测量AEDs的血浆游离分数。
