Kumlien E, Bergström M, Lilja A, Andersson J, Szekeres V, Westerberg C E, Westerberg G, Antoni G, Långström B
Department of Neurology, University Hospital, Uppsala, Sweden.
Epilepsia. 1995 Jul;36(7):712-21. doi: 10.1111/j.1528-1157.1995.tb01051.x.
We performed positron emission tomography (PET) with [11C]deuterium-deprenyl in 9 patients with temporal lobe epilepsy (TLE) undergoing evaluation for possible epilepsy surgery. Seven patients had unilateral and 2 had bilateral mesiotemporal epileptic foci based on the preoperative investigation including ictal EEG discharges and PET with 2-[18F]fluoro-2-deoxyglucose (FDG). Deprenyl is an irreversible inhibitor of monoamine oxidase type B (MAO-B) with a very high affinity for the enzyme. In the brain, MAO-B is preferentially located in astrocytes, and a previous in vitro study showed increased binding of the ligand in sclerotic hippocampi. Dynamically acquired N-[methyl-11C]-a,a-di-deutero-L-deprenyl distribution in PET images were analyzed graphically, and the focus regions were assessed visually on the PET images. In addition, the accumulation rate and distribution volume of the tracer relative to the cerebellar cortex were measured in standardized homologous temporal regions by semiquantitative methods. Uptake of [11C]deuterium-deprenyl was significantly increased in the epileptogenic temporal lobes, both apparently and semiquantitatively. By calculating mean interlobar ratios, we identified the temporal lobe containing the epileptic focus in six unilateral cases. One case was ambiguous but was not falsely localized. The two bilateral cases were correctly identified as such. Our results suggest that PET with [11C]deuterium-deprenyl might be a useful method for identification of epileptogenic temporal lobes.
我们对9例因可能行癫痫手术而接受评估的颞叶癫痫（TLE）患者进行了[11C]氘代司来吉兰正电子发射断层扫描（PET）检查。根据术前检查，包括发作期脑电图放电以及2-[18F]氟-2-脱氧葡萄糖（FDG）PET检查，7例患者有单侧颞叶癫痫病灶，2例有双侧内侧颞叶癫痫病灶。司来吉兰是一种不可逆的单胺氧化酶B型（MAO-B）抑制剂，对该酶具有非常高的亲和力。在大脑中，MAO-B主要位于星形胶质细胞中，先前的一项体外研究表明，在硬化的海马体中该配体的结合增加。对PET图像中动态采集的N-[甲基-11C]-α,α-二氘代-L-司来吉兰分布进行图像分析，并在PET图像上目视评估病灶区域。此外，通过半定量方法在标准化的同源颞叶区域测量示踪剂相对于小脑皮质的积聚率和分布容积。[11C]氘代司来吉兰在致痫颞叶中的摄取在表观和半定量方面均显著增加。通过计算平均叶间比值，我们在6例单侧病例中确定了含有癫痫病灶的颞叶。1例情况不明确，但未出现错误定位。2例双侧病例也被正确识别。我们的结果表明，[11C]氘代司来吉兰PET检查可能是一种识别致痫颞叶的有用方法。
