Semah F, Baulac M, Hasboun D, Frouin V, Mangin J F, Papageorgiou S, Leroy-Willig A, Philippon J, Laplane D, Samson Y
DRIPP, Service Hospitalier F. Joliot, CEA, Orsay, France.
Epilepsia. 1995 May;36(5):447-56. doi: 10.1111/j.1528-1157.1995.tb00485.x.
The mechanism of interictal glucose hypometabolism remains unclear, but this abnormality occurs more frequently in temporal lobe epilepsy (TLE) than in other types of partial epilepsy. Therefore temporal hypometabolism has been suggested to reflect mesial temporal sclerosis (MTS). To investigate this, we selected 22 patients with refractory partial epilepsy of mesial temporal lobe origin (MTLE) who had hippocampal atrophy based on magnetic resonance imaging (MRI) volumetric analysis. We then analyzed the metabolic correlates of unilateral hippocampal atrophy. Thirteen temporal regions of interest (ROI) were defined on MRI scans for each individual and then applied to high-resolution FDG-positron emission tomography (PET) images obtained parallel to the long axis of the hippocampus. The most hypometabolic regions were the temporal pole and the hippocampal region. When we analyzed ensembles of temporal regions grouped into related networks, the temporolimbic network, which included the hippocampal region and the temporal pole, was abnormal in 95% of the patients at a 3-SD threshold. PET hypometabolism was highly correlated with the degree of hippocampal atrophy in this network, but not in other parts of the temporal lobe, which were less frequently hypometabolic. These data indicate that hypometabolism is a consequence of MTS in the temporolimbic region but not necessarily in the other parts of the temporal lobe. Our results also suggest that the combination of PET and MRI may facilitate the noninvasive diagnosis of MTLE.
发作间期葡萄糖代谢减低的机制尚不清楚，但这种异常在颞叶癫痫（TLE）中比在其他类型的部分性癫痫中更常见。因此，颞叶代谢减低被认为反映了内侧颞叶硬化（MTS）。为了对此进行研究，我们选择了22例源自内侧颞叶的难治性部分性癫痫（MTLE）患者，这些患者基于磁共振成像（MRI）容积分析显示有海马萎缩。然后我们分析了单侧海马萎缩的代谢相关性。在MRI扫描上为每个个体定义了13个颞叶感兴趣区（ROI），然后将其应用于与海马长轴平行获取的高分辨率氟代脱氧葡萄糖正电子发射断层扫描（PET）图像。代谢减低最明显的区域是颞极和海马区。当我们分析分组为相关网络的颞叶区域集合时，包括海马区和颞极的颞叶边缘网络在3个标准差阈值下95%的患者中存在异常。在这个网络中，PET代谢减低与海马萎缩程度高度相关，但在颞叶其他较少出现代谢减低的部位则不然。这些数据表明，代谢减低是颞叶边缘区域MTS的结果，但不一定是颞叶其他部位的结果。我们的结果还表明，PET和MRI的联合应用可能有助于MTLE的无创诊断。
