Department of Nuclear Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
iHuman Institute, ShanghaiTech University, Shanghai 201210, China; School of Life Science and Technology, ShanghaiTech University, Shanghai 201210, China; University of Chinese Academy of Sciences, Beijing 100049, China.
EBioMedicine. 2022 May;79:104004. doi: 10.1016/j.ebiom.2022.104004. Epub 2022 Apr 15.
In drug-resistant epilepsy, surgical resection of the epileptic focus can end seizures. However, success is dependent on the ability to identify foci locations and, unfortunately, current methods like electrophysiology and positron emission tomography can give contradictory results. During seizures, glucose is metabolized at epileptic foci through aerobic glycolysis, which can be imaged through the oxygen-glucose index (OGI) biomarker. However, inter-ictal (between seizures) OGI changes have not been studied, which has limited its application.
18 healthy controls and 24 inter-ictal, temporal lobe epilepsy patients underwent simultaneous positron emission tomography (PET) and magnetic resonance imaging (MRI) scans. We used [F]fluorodeoxyglucose-PET (FDG-PET) to detect cerebral glucose metabolism, and calibrated functional MRI to acquire relative oxygen consumption. With these data, we calculated relative OGI maps.
While bilaterally symmetrical in healthy controls, we observed, in patients during the inter-ictal period, higher OGI ipsilateral to the epileptic focus than contralateral. While traditional FDG-PET results and temporal lobe OGI results usually both agreed with invasive electrophysiology, in cases where FDG-PET disagreed with electrophysiology, temporal lobe OGI agreed with electrophysiology, and vice-versa.
As either our novel epilepsy biomarker or traditional approaches located foci in every case, our work provides promising insights into metabolic changes in epilepsy. Our method allows single-session OGI measurement which can be useful in other diseases.
This work was supported by ShanghaiTech University, the Shanghai Municipal Government, the National Natural Science Foundation of China Grant (No. 81950410637) and Shanghai Municipal Key Clinical Specialty (No. shslczdzk03403). F. H. and P. H. were supported by USA National Institute of Health grants (R01 NS-100106, R01 MH-067528).Z. W. was supported by the Key-Area Research and Development Program of Guangdong Province (2019B030335001), National Natural Science Foundation of China (No. 82151303), and National Key R&D Program of China (No. 2021ZD0204002).
在耐药性癫痫中，通过手术切除癫痫灶可以终止癫痫发作。然而，手术的成功与否取决于能否准确识别病灶位置，而目前的一些方法，如电生理学和正电子发射断层扫描（PET），其结果可能存在矛盾。在癫痫发作期间，葡萄糖通过有氧糖酵解在癫痫灶中代谢，这可以通过氧葡萄糖指数（OGI）生物标志物进行成像。然而，由于对发作间期（发作之间）OGI 变化的研究有限，其应用受到了限制。
18 名健康对照者和 24 名发作间期颞叶癫痫患者接受了正电子发射断层扫描（PET）和磁共振成像（MRI）的同步扫描。我们使用[F]氟脱氧葡萄糖-PET（FDG-PET）来检测脑葡萄糖代谢，并通过校准功能磁共振成像来获取相对氧消耗。利用这些数据，我们计算了相对 OGI 图谱。
在健康对照组中，OGI 左右两侧对称，但在发作间期的患者中，与癫痫灶同侧的 OGI 高于对侧。虽然传统的 FDG-PET 结果和颞叶 OGI 结果通常与侵袭性电生理学结果一致，但在 FDG-PET 与电生理学结果不一致的情况下，颞叶 OGI 与电生理学结果一致，反之亦然。
由于我们的新型癫痫生物标志物或传统方法都能定位每个病例的病灶，因此我们的工作为癫痫代谢变化提供了有前景的见解。我们的方法允许在单次检查中测量 OGI，可以在其他疾病中应用。
本工作得到了上海科技大学、上海市政府、国家自然科学基金（No. 81950410637）和上海市重点临床专科（No. shslczdzk03403）的支持。F.H.和 P.H.得到了美国国立卫生研究院资助（R01 NS-100106、R01 MH-067528）。Z.W.得到了广东省重点领域研发计划（2019B030335001）、国家自然科学基金（No. 82151303）和国家重点研发计划（No. 2021ZD0204002）的支持。
