Lateralized periodic discharges frequency correlates with glucose metabolism
Lateralized periodic discharges frequency correlates with glucose metabolism
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DOI：
10.1212/wnl.0000000000006903
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发表时间：
2019-02-12
期刊：
影响因子：
9.9
通讯作者：
Struck, Aaron F.
中科院分区：
文献类型：
--
作者：
Subramaniam, Thanujaa;Jain, Aditya;Struck, Aaron F.
目的探讨偏侧周期性放电（LPDs）和葡萄糖代谢的F-18-氟脱氧葡萄糖（FDG）-PET.MethodsWe的特点之间的相关性回顾性分析的医疗记录，以确定患者进行FDG-PET在EEG监测与LPDs目前在FDG摄取期间。两名盲态委员会认证的神经生理学家独立解释EEG。FDG摄取采用标准化摄取值（SUV）测量。将结构图像与PET图像融合以帮助定位SUV。两名PET阅读器独立测量最大SUV。通过将最大SUV归一化为脑桥的SUV（SUVRpons）获得相对SUV值。将LPD频率作为分类变量和连续测量进行分析。其他次要变量包括持续时间，振幅，结构性病变的存在，和“加”EEG功能，如节奏或快速尖锐activity.ResultsNine患者被确定和7个结构性病因LPDs。使用频率作为分类变量和连续变量的分析显示，LPD频率增加与同侧SUVR桥脑增加之间存在相关性（p = 0.02）。与LPD相关的代谢（0.5 Hz作为基线）在1 Hz时增加了100%的中位数，而频率>1 Hz时增加了309%的中位数。有没有统计学上的显着差异，SUVRpons的其他因素，包括持续时间（p = 0.10），幅度（p = 0.80），结构病因（p = 0.55），或“加”功能，如节奏或快速尖锐的活动（p = 0.84）。LPD频率应该是一个衡量利益时，制定神经保护策略，在严重的神经系统疾病。
ObjectiveTo investigate the correlation between characteristics of lateralized periodic discharges (LPDs) and glucose metabolism measured by F-18-fluorodeoxyglucose (FDG)-PET.MethodsWe retrospectively reviewed medical records to identify patients who underwent FDG-PET during EEG monitoring with LPDs present during the FDG uptake period. Two blinded board-certified neurophysiologists independently interpreted EEGs. FDG uptake was measured using standardized uptake value (SUV). Structural images were fused with PET images to aid with localization of SUV. Two PET readers independently measured maximum SUV. Relative SUV values were obtained by normalization of the maximum SUV to the SUV of pons (SUVRpons). LPD frequency was analyzed both as a categorical variable and as a continuous measure. Other secondary variables included duration, amplitude, presence of structural lesion, and "plus" EEG features such as rhythmic or fast sharp activity.ResultsNine patients were identified and 7 had a structural etiology for LPDs. Analysis using frequency as a categorical variable and continuous variable showed an association between increased LPD frequency and increased ipsilateral SUVRpons (p = 0.02). Metabolism associated with LPDs (0.5 Hz as a baseline) increased by a median of 100% at 1 Hz and for frequencies >1 Hz increased by a median of 309%. There were no statistically significant differences in SUVRpons for other factors including duration (p = 0.10), amplitude (p = 0.80), structural etiology (p = 0.55), or "plus" features such as rhythmic or fast sharp activity (p = 0.84).ConclusionsMetabolic activity increases monotonically with LPD frequency. LPD frequency should be a measure of interest when developing neuroprotection strategies in critical neurologic illness.