IN-VIVO CEREBRAL METABOLISM AND CENTRAL BENZODIAZEPINE-RECEPTOR BINDING IN TEMPORAL-LOBE EPILEPSY
IN-VIVO CEREBRAL METABOLISM AND CENTRAL BENZODIAZEPINE-RECEPTOR BINDING IN TEMPORAL-LOBE EPILEPSY
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DOI：
10.1212/wnl.43.10.1998
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发表时间：
1993-10-01
期刊：
影响因子：
9.9
通讯作者：
KUHL, DE
中科院分区：
文献类型：
--
作者：
HENRY, TR;FREY, KA;KUHL, DE
正电子发射断层扫描测量发作间期脑葡萄糖代谢[F-18]氟脱氧葡萄糖和中央苯二氮卓受体结合[C-11]氟马西尼在10个内侧颞叶癫痫（TLE）患者和正常人。8例TLE患者在EEG发作期同侧出现颞中、颞外侧和丘脑代谢低下，4例出现额外的颞外代谢低下。1例仅单侧前内侧颞叶代谢减退，1例代谢正常。每例患者的同侧前内侧颞区苯二氮卓类受体结合减少，无新皮质变化。因此，发作间期代谢功能障碍是可变的，通常广泛的TLE，而减少中央苯二氮卓受体密度更局限于近中颞区。TLE的代谢模式可能反映神经联系不能，而苯二氮卓类受体的变化可能反映了致痫区特有的局部神经元和突触丢失。[C-11]氟马西尼显像可用于难治性复杂部分性癫痫的术前评估。
Positron emission tomography measured interictal cerebral glucose metabolism with [F-18]fluorodeoxyglucose and central benzodiazepine-receptor binding with [C-11]flumazenil in 10 mesial temporal lobe epilepsy (TLE) patients and in normal subjects. Eight TLE patients had mesial temporal, lateral temporal, and thalamic hypometabolism ipsilateral to EEG ictal onsets, with additional extratemporal hypometabolism in four. One had unilateral anterior mesial temporal hypometabolism only, and one had normal metabolism. Each patient had decreased benzodiazepine-receptor binding in the ipsilateral anterior mesial temporal region, without neocortical changes. Thus, interictal metabolic dysfunction is variable and usually extensive in TLE, whereas decreased central benzodiazepine-receptor density is more restricted to mesial temporal areas. Metabolic patterns in TLE may reflect diaschisis, while benzodiazepine-receptor changes may reflect localized neuronal and synaptic loss that is specific to the epileptogenic zone. [C-11]Flumazenil imaging may be useful in presurgical evaluation of refractory complex partial seizures.