Breier J I, Mullani N A, Thomas A B, Wheless J W, Plenger P M, Gould K L, Papanicolaou A, Willmore L J
Department of Neurosurgery, University of Texas Health Science Center, Houston 77030, USA.
Neurology. 1997 Apr;48(4):1047-53. doi: 10.1212/wnl.48.4.1047.
We derived interhemispheric asymmetry indices (AIs) in interictal glucose uptake and blood flow in the temporal lobes of patients with intractable complex partial seizures from 18F and 15O positron emission tomograms. All patients subsequently underwent either left (n = 16) and right (n = 18) temporal lobectomy. We determined the effects on AIs of clinical seizure variables, including duration of seizure disorder, age at seizure onset, frequency of complex partial seizures, history of secondary generalization, history of febrile seizures, and magnetic resonance imaging evidence for mesial temporal sclerosis. Duration of seizure disorder produced the only significant effects. Degree of interhemispheric asymmetry in both glucose uptake and blood flow increased with duration of seizure disorder. However, the rate of increase in asymmetry was significantly greater for glucose uptake than for blood flow. These results indicate that uncoupling of metabolism and blood flow is a progressive process that results from the differential response of glucose metabolism and blood flow to chronic seizure activity. The results also suggest that duration of seizure disorder may be an important variable to consider in the interpretation of PET studies for evaluation of seizure surgery candidates.
我们从18F和15O正电子发射断层扫描图中得出了难治性复杂部分性癫痫患者颞叶发作间期葡萄糖摄取和血流的半球间不对称指数（AI）。所有患者随后均接受了左侧（n = 16）或右侧（n = 18）颞叶切除术。我们确定了临床癫痫变量对AI的影响，这些变量包括癫痫发作紊乱的持续时间、癫痫发作起始年龄、复杂部分性癫痫发作频率、继发性全面发作病史、热性惊厥病史以及内侧颞叶硬化的磁共振成像证据。癫痫发作紊乱的持续时间产生了唯一显著的影响。葡萄糖摄取和血流的半球间不对称程度均随癫痫发作紊乱的持续时间增加。然而，葡萄糖摄取的不对称增加速率显著大于血流。这些结果表明，代谢与血流的解偶联是一个渐进过程，是葡萄糖代谢和血流对慢性癫痫活动的不同反应导致的。结果还表明，癫痫发作紊乱的持续时间可能是在解释用于评估癫痫手术候选者的PET研究时需要考虑的一个重要变量。
