APHM, Hôpital de la Timone, Service Central de Biophysique et Médecine Nucléaire, 13005 Marseille, France.
Epilepsy Res. 2012 Sep;101(3):237-45. doi: 10.1016/j.eplepsyres.2012.04.008. Epub 2012 May 1.
This study aims to contribute to the identification of selective brain regions involved in hyperkinetic behaviors. We studied the whole-brain voxel-based interictal metabolic 18FDG-PET pattern of 23 patients with hyperkinetic seizures, in comparison with both 15 healthy subjects similar for age and gender, and 23 patients without hyperkinetic seizures. Patients were in particular similar for the localization of the epileptogenic zone, this having been defined using stereoelectroencephalography (SEEG) when clinically indicated (15/23 patients with hyperkinetic seizures and 13/23 patients without hyperkinetic seizures). Using conjunction voxel-based analysis, patients with hyperkinetic seizures exhibited significant hypometabolism within bilateral midbrain and the right caudate head, in comparison both to healthy subjects (p<0.05, FDR-corrected for the voxel) and to patients without hyperkinetic seizures (p<0.0167, uncorrected for the voxel). Findings were secondarily confirmed separately in each subgroup of patients with frontal, temporal or posterior epilepsy. These findings argue for a specific subcortical metabolic impairment in patients with hyperkinetic seizures, within brain structures supposed to be involved in the generation of primitive motor programs.
本研究旨在确定与运动过度行为相关的特定脑区。我们比较了 23 例运动过度性癫痫患者、15 名年龄和性别相匹配的健康对照者和 23 例无运动过度性癫痫患者的全脑基于体素的发作间期 18FDG-PET 代谢模式。患者在致痫区的定位上尤其相似，当临床需要时（23 例运动过度性癫痫患者中有 15 例和 23 例无运动过度性癫痫患者中有 13 例），使用立体脑电图（SEEG）来定义致痫区。采用基于体素的联合分析，与健康对照者（经体素校正的 FDR 校正，p<0.05）和无运动过度性癫痫患者（未经体素校正的 p<0.0167）相比，运动过度性癫痫患者双侧中脑和右侧尾状核头部均表现出明显的代谢低下（p<0.0167，未经体素校正）。这些发现分别在额叶、颞叶或后部癫痫患者的每个亚组中得到了进一步证实。这些发现表明，运动过度性癫痫患者存在特定的皮质下代谢障碍，涉及产生原始运动程序的脑结构。
