Stockholm Brain Institute, and Department of Clinical Neuroscience, Karolinska Institutet, Sweden.
Neuroimage. 2010 Jun;51(2):606-15. doi: 10.1016/j.neuroimage.2010.02.051. Epub 2010 Feb 24.
The present study tests the hypothesis that the dopamine system is altered in idiopathic generalized epilepsy (IGE), and that the pattern of possible changes differs between juvenile myoclonic epilepsy (JME) and epilepsy with tonic-clonic seizures only (GTCS). The dopamine (DA) system was investigated with PET and a DA transporter (DAT) ligand [(11)C]PE2I in 13 patients with JME, 13 with GTCS, and 12 healthy controls. The binding potential (BP) to DAT was quantified in the caudate, putamen, and midbrain. The possible impact on function was evaluated by correlating regional BP with test performance in a battery of neuropsychological tests. Both patient groups showed a reduced BP compared to controls, albeit in different locations. JME patients had a lower tracer binding than controls in the midbrain (0.8+/-0.1 vs. 1.0+/-0.2, p=0.019), whereas GTCS patients had reduced tracer binding in the putamen (5.9+/-1.6 vs. 7.1+/-1.2, p=0.023). While GTCS patients showed impaired performance in motor functions and on one test of executive function, JME patients performed poorly also in tests of working memory and several tests of executive function. Alterations in the DA system seem to exist in both GTCS and JME. However, the regional distribution of these changes differs between the two syndromes, as does their association with psychomotor and working memory performance. The present data suggest that the two forms of IGE have different neuronal substrates.
特发性全面性癫痫（IGE）患者的多巴胺系统发生改变，且青少年肌阵挛癫痫（JME）和仅有强直-阵挛发作的癫痫（GTCS）患者的多巴胺系统可能出现不同的变化模式。我们使用正电子发射断层扫描（PET）和多巴胺转运体（DAT）配体[11C]PE2I 研究了 13 名 JME 患者、13 名 GTCS 患者和 12 名健康对照者的多巴胺（DA）系统。在尾状核、壳核和中脑定量了 DA 转运体（DAT）的结合势（BP）。通过将局部 BP 与神经心理学测试的测试表现相关联，评估了功能的可能影响。与对照组相比，两个患者组的 BP 均降低，尽管位置不同。JME 患者的中脑 BP 低于对照组（0.8+/-0.1 对 1.0+/-0.2，p=0.019），而 GTCS 患者的壳核 BP 降低（5.9+/-1.6 对 7.1+/-1.2，p=0.023）。GTCS 患者在运动功能和执行功能的一项测试中表现受损，而 JME 患者在工作记忆和几项执行功能测试中表现也不佳。DA 系统的改变似乎存在于 GTCS 和 JME 中。然而，这些变化在两个综合征之间的区域分布不同，与运动和工作记忆表现的关联也不同。本研究数据表明，这两种 IGE 有不同的神经元基础。
