Department of Neurology, Yonsei University College of Medicine, Seoul, Korea.
Department of Neurology, Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Korea.
J Neuroimaging. 2022 Mar;32(2):300-313. doi: 10.1111/jon.12941. Epub 2021 Oct 22.
The aim of this study was to investigate differences in metabolic networks based on preoperative fluorodeoxyglucose (FDG)-positron emission tomography (PET) in temporal lobe epilepsy (TLE) with hippocampal sclerosis (HS) between patients with complete seizure-free (SF) and those with noncomplete seizure-free (non-SF) after anterior temporal lobectomy.
This study was retrospectively performed at a tertiary hospital. We recruited pathologically confirmed 75 TLE patients with HS who underwent preoperative FDG-PET. All patients underwent a standard anterior temporal lobectomy. The surgical outcome was evaluated at least 12 months after surgery, and we divided the subjects into patients with SF (International League Against Epilepsy [ILAE] class I) and those with non-SF (ILAE class II-VI). We evaluated the metabolic network using graph theoretical analysis based on FDG-PET. We investigated the differences in network measures between the two groups.
Of the 75 TLE patients with HS, 32 patients (42.6%) had SF, whereas 43 patients (57.3%) had non-SF. There were significant differences in global metabolic networks according to surgical outcomes. The patients with SF had a lower assortative coefficient than those with non-SF (-0.020 vs. -0.009, p = .044). We also found widespread regional differences in local metabolic networks according to surgical outcomes.
Our study demonstrates significant differences in preoperative metabolic networks based on FDG-PET in TLE patients with HS according to surgical outcomes. This work introduces a metabolic network based on FDG-PET and can be used as a potential tool for predicting surgical outcome in TLE patients with HS.
本研究旨在探讨基于术前氟脱氧葡萄糖（FDG）-正电子发射断层扫描（PET）的代谢网络在伴有海马硬化（HS）的颞叶癫痫（TLE）患者中，在前颞叶切除术（ATL）后完全无癫痫发作（SF）和非完全无癫痫发作（非 SF）患者之间的差异。
本研究在一家三级医院进行回顾性研究。我们招募了 75 例经病理证实的伴有 HS 的 TLE 患者，这些患者均接受了术前 FDG-PET 检查。所有患者均接受了标准的 ATL。术后至少 12 个月对手术结果进行评估，并将受试者分为 SF 患者（国际抗癫痫联盟[ILAE] I 级）和非 SF 患者（ILAE II-VI 级）。我们使用基于 FDG-PET 的图论分析评估代谢网络，并研究了两组之间网络指标的差异。
在 75 例伴有 HS 的 TLE 患者中，32 例（42.6%）患者术后 SF，而 43 例（57.3%）患者术后非 SF。根据手术结果，全局代谢网络存在显著差异。SF 患者的聚类系数低于非 SF 患者（-0.020 与-0.009，p =.044）。我们还发现，根据手术结果，局部代谢网络存在广泛的区域性差异。
我们的研究表明，基于 FDG-PET 的术前代谢网络在伴有 HS 的 TLE 患者中根据手术结果存在显著差异。这项工作介绍了一种基于 FDG-PET 的代谢网络，可以作为预测伴有 HS 的 TLE 患者手术结果的潜在工具。
