SPECT perfusion changes during complex partial seizures in patients with hippocampal sclerosis.
SPECT perfusion changes during complex partial seizures in patients with hippocampal sclerosis.
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DOI：
10.1093/brain/awg108
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发表时间：
2003-05
期刊：
影响因子：
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通讯作者：
W. Paesschen;P. Dupont;G. V. Driel;H. V. Billoen;A. Maes
中科院分区：
文献类型：
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作者：
W. Paesschen;P. Dupont;G. V. Driel;H. V. Billoen;A. Maes
脑灌注变化可靠地反映了神经元活动的变化。我们的目的是利用间歇期和间歇期单光子发射计算机断层扫描（SPECT）获得海马硬化症（HS）患者复杂部分性癫痫（CPS）的病理生理学新见解。我们研究了24例难治性颞叶癫痫（TLE）合并HS。所有患者在CPS早期注射时均有间期和初期SPECT。对图像进行归一化和共配准。采用统计参数作图（SPM99），确定有显著脑血流灌注变化的脑区。为了评估这些区域之间可能存在的相互关系，我们计算了Pearson相关系数。癫痫病灶的同侧颞叶、同侧额叶中部和中央前回边界、双侧枕叶和对侧中央后回的两个小区域均表现为头侧性高灌注。额叶、对侧小脑后部及同侧楔前叶灌注不足。进一步的探索性分析表明，同侧颞叶过度灌注与同侧额叶灌注不足之间存在关联，癫痫发作持续时间与同侧小脑前部和对侧中央后回过度灌注之间呈负相关。我们得出结论，HS患者在CPS期间存在一个灌注改变网络。在特定的时间窗口内，通过周周SPECT研究HS患者的特定癫痫发作类型，可以进一步分析大脑网络活动，以及与HS相关的癫痫发作期间的兴奋性、抑制性和门控机制。
Cerebral perfusion changes reliably reflect changes in neuronal activity. Our aim was to obtain new insights into the pathophysiology of complex partial seizures (CPS) in patients with hippocampal sclerosis (HS) using interictal and ictal single photon emission computed tomography (SPECT). We studied 24 patients with refractory temporal lobe epilepsy (TLE) associated with HS. All had an interictal and ictal SPECT with early injection during a CPS. Images were normalized and co-registered. Using statistical parametric mapping (SPM99), brain regions with significant ictal perfusion changes were determined. To assess possible interrelationships between these regions, Pearson correlation coefficients were calculated. The temporal lobe ipsilateral to the seizure focus, the border of the ipsilateral middle frontal and precentral gyrus, both occipital lobes and two small regions in the contralateral postcentral gyrus showed ictal hyperperfusion. The frontal lobes, contralateral posterior cerebellum and ipsilateral precuneus showed hypoperfusion. Further exploratory analysis suggested an association between ipsilateral temporal lobe hyperperfusion and ipsilateral frontal lobe hypoperfusion, and an inverse association between seizure duration and hyperperfusion in the ipsilateral anterior cerebellum and contralateral postcentral gyrus. We conclude that there is a network of perfusion changes during CPS in patients with HS. Studying a particular seizure type in patients with HS with peri-ictal SPECT performed during a defined time window will allow further analysis of the cerebral network activities, and excitatory, inhibitory and gating mechanisms during seizures associated with HS.