NMDA-receptor activity visualized with (S)-[N-methyl-11C]ketamine and positron emission tomography in patients with medial temporal lobe epilepsy
NMDA-receptor activity visualized with (S)-[N-methyl-11C]ketamine and positron emission tomography in patients with medial temporal lobe epilepsy
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DOI：
10.1111/j.1528-1157.1999.tb01985.x
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发表时间：
1999-01-01
期刊：
影响因子：
5.6
通讯作者：
Långström, B
中科院分区：
文献类型：
--
作者：
Kumlien, E;Hartvig, P;Långström, B
目的：探讨内侧颞叶癫痫患者中N-甲基-D-天冬氨酸受体门控离子通道的神经化学激活是否呈现定量变化，即与C-11标记的S-[N-甲基]氯胺酮的结合。方法：对8例接受癫痫手术的内侧颞叶癫痫患者进行正电子发射断层扫描。术前检查包括磁共振成像(MRI)、18F-氟代脱氧葡萄糖(18FDG)正电子发射计算机断层扫描(FDG)和视频脑电监测癫痫发作。结果：(S)-[N-甲基-C-11]氯胺酮迅速进入脑内，纹状体、丘脑核团和皮质区有较高的放射性水平。总体而言，(S)-[N-甲基-C-11]氯胺酮的脑摄取和区域结合电位与先前在健康对照组中观察到的测量结果相似。然而，在给药20分钟后，当血流影响可以忽略不计时，两侧比较显示发作期颞叶示踪剂放射性降低9-34%。在早期，结合电位的差异不太明显，为9-21%。减少的程度和分布与18FDG正电子发射计算机断层扫描的代谢模式相似。结论：TLE患者颞叶静脉注射S-[N-甲基-C-11]氯胺酮后放射性摄取减少。这可能反映了NMDA受体密度降低、血流灌注减少、局灶性萎缩或其他因素。
Purpose: To determine whether neurochemical activation of the N-methyl-D-aspartate (NMDA) receptor-gated ion channel shows quantitative changes, measured as binding of C-11-labeled (S)-[N-methyl]ketamine, in patients with medial temporal lobe epilepsy (MTLE).Methods: Eight patients with MTLE who were evaluated regarding epilepsy surgery underwent positron emission tomography (PET) with (S)-[N-methyl-C-11]ketamine. The presurgical investigations included magnetic resonance imaging (MRI), PET with F-18-fluoro-deoxyglucose ((18)FDG), and seizure monitoring by using video-EEG. The uptake of (S)-[N-methyl-C-11]ketamine in the temporal lobe of ictal onset was compared with the contralateral side and correlated to changes in regional glucose metabolism measured by PET with (18)FDG.Results: (S)-[N-methyl-C-11]ketamine rapidly reached the brain, and high radioactivities were measured in the striatum, thalamic nuclei, and cortical regions. Overall the brain uptake and regional binding potentials of (S)-[N-methyl-C-11]ketamine were similar to measurements observed previously in healthy controls. However, 20 min after administration, when blood flow influence was negligible, a side-to-side comparison revealed a 9-34% reduction of tracer radioactivity in the temporal lobes of ictal onset. At earlier times, the differences in binding potentials were less pronounced, 9-21%. The magnitude and distribution of the reduction were similar to the metabolic pattern seen on PET scans with (18)FDG.Conclusions: Radioactivity uptake of intravenously administered (S)-[N-methyl-C-11]ketamine was reduced in temporal lobes of ii tal in patients with TLE. This may reflect reduced NMDA-receptor density, reduced perfusion, focal atrophy, or other factors.