Shan Yi, Zhou Hu-Cheng, Shang Kun, Cui Bi-Xiao, Fan Xiao-Tong, Zhang Qi, Shan Yong-Zhi, Jiang Jie-Hui, Zhao Guo-Guang, Lu Jie
Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing 100053, China.
Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing 100053, China.
Biology (Basel). 2022 Aug 5;11(8):1178. doi: 10.3390/biology11081178.
(1) Background: Accurate localization of the epileptogenic zone and understanding the related functional connectivity (FC) alterations are critical for the prediction of clinical prognosis in patients with temporal lobe epilepsy (TLE). We aim to localize the hypometabolic region in TLE patients, compare the differences in FC alterations based on hypometabolic region and structural lesion, respectively, and explore their relationships with clinical prognosis. (2) Methods: Thirty-two TLE patients and 26 controls were recruited. Patients underwent 18F-FDG PET/MR scan, surgical treatment, and a 2−3-year follow-up. Visual assessment and voxel-wise analyses were performed to identify hypometabolic regions. ROI-based FC analyses were performed. Relationships between clinical prognosis and FC values were performed by using Pearson correlation analyses and receiver operating characteristic (ROC) analysis. (3) Results: Hypometabolic regions in TLE patients were found in the ipsilateral hippocampus, parahippocampal gyrus, and temporal lobe (p < 0.001). Functional alterations based on hypometabolic regions showed a more extensive whole-brain FC reduction. FC values of these regions negatively correlated with epilepsy duration (p < 0.05), and the ROC curve of them showed significant accuracy in predicting postsurgical outcome. (4) Conclusions: In TLE patients, FC related with hypometabolic region obtained by PET/fMRI may provide value in the prediction of disease progression and seizure-free outcome.
(1) 背景：准确确定致痫区并了解相关功能连接（FC）改变对于颞叶癫痫（TLE）患者临床预后的预测至关重要。我们旨在定位TLE患者的低代谢区域，分别比较基于低代谢区域和结构病变的FC改变差异，并探讨它们与临床预后的关系。(2) 方法：招募了32例TLE患者和26名对照。患者接受了18F-FDG PET/MR扫描、手术治疗及2至3年的随访。进行视觉评估和体素分析以识别低代谢区域。进行基于感兴趣区（ROI）的FC分析。通过Pearson相关分析和受试者工作特征（ROC）分析来分析临床预后与FC值之间的关系。(3) 结果：TLE患者的低代谢区域位于同侧海马、海马旁回和颞叶（p < 0.001）。基于低代谢区域的功能改变显示全脑FC降低更为广泛。这些区域的FC值与癫痫病程呈负相关（p < 0.05），并且它们的ROC曲线在预测术后结果方面显示出显著的准确性。(4) 结论：在TLE患者中，通过PET/fMRI获得的与低代谢区域相关的FC可能在预测疾病进展和无癫痫发作结果方面具有价值。
