Université de Lorraine, Department of Nuclear Medicine and Nancyclotep Imaging Platform, CHRU Nancy, F-54000 Nancy, France; Université de Lorraine, IADI, INSERM U1254, F-54000 Nancy, France.
Université de Lorraine, Department of Nuclear Medicine and Nancyclotep Imaging Platform, CHRU Nancy, F-54000 Nancy, France.
Neuroimage Clin. 2022;36:103210. doi: 10.1016/j.nicl.2022.103210. Epub 2022 Sep 24.
F-FDG PET provides high sensitivity for the pre-surgical assessment of drug-resistant temporal lobe epilepsy (TLE). However, little is known about the metabolic connectivity of epileptogenic networks involved. This study therefore aimed to evaluate the association between metabolic connectivity and seizure outcome in surgically treated TLE.
The study included 107 right-handed patients that had undergone a presurgical interictal F-FDG PET assessment followed by an anterior temporal lobectomy and were classified according to seizure outcome 2 years after surgery. Metabolic connectivity was evaluated by seed correlation analysis in left and right epilepsy patients with a Class Engel IA or > IA outcome and compared to age-, sex- and handedness-matched healthy controls.
Increased metabolic connectivity was observed in the >IA compared to the IA group within the operated temporal lobe (respective clusters of 7.5 vs 3.3 cm and 2.6 cm vs 2.2 cm in left and right TLE), and to a lower extent with the contralateral temporal lobe (1.2 vs 0.7 cm and 1.7 cm vs 0.7 cm in left and right TLE). Seed correlations provided added value for the estimated individual performance of seizure outcome over the group comparisons in left TLE (AUC of 0.74 vs 0.67).
Metabolic connectivity is associated with outcome in surgically treated TLE with a strengthened epileptogenic connectome in patients with non-free-seizure outcomes. The added value of seed correlation analysis in left TLE underlines the importance of evaluating metabolic connectivity in network related diseases.
评估代谢连通性与手术治疗颞叶癫痫（TLE）患者术后发作结局的相关性。
本研究纳入了 107 例右利手患者，这些患者在接受手术前进行了癫痫发作间期 F-FDG PET 评估，并根据术后 2 年的发作结局进行了分类。通过对左、右 TLE 中具有 Engel IA 或更高分类结果的癫痫患者进行种子相关分析，评估代谢连通性，并与年龄、性别和利手相匹配的健康对照者进行比较。
与 IA 组相比，>IA 组患者手术侧颞叶内（左、右 TLE 中分别为 7.5cm3 和 3.3cm3，2.6cm3 和 2.2cm3），以及在一定程度上对侧颞叶内（左、右 TLE 中分别为 1.2cm3 和 0.7cm3，1.7cm3 和 0.7cm3）的代谢连通性增加。与组间比较相比，种子相关分析为左侧 TLE 中估计的个体发作结局表现提供了附加价值（AUC 为 0.74 比 0.67）。
代谢连通性与手术治疗 TLE 的结局相关，在非无发作结局的患者中，癫痫网络的连通性增强。在左侧 TLE 中，种子相关分析的附加价值强调了在网络相关疾病中评估代谢连通性的重要性。
