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"Magnetic resonance imaging negative positron emission tomography positive" temporal lobe epilepsy: FDG-PET pattern

R P Carne1, M J Cook, L R MacGregor

  • 1Victorian Epilepsy Centre, St. Vincent's Hospital, Melbourne, Victoria, Australia. carnero@svhm.org.au

Molecular Imaging and Biology
|December 21, 2006
PubMed
Abstract

Insights

Patients with temporal lobe epilepsy (TLE) without hippocampal sclerosis (HS) on MRI show distinct patterns of brain metabolism. These findings highlight differences in hypometabolism in MRI-negative TLE.

Area of Science:

  • Neuroimaging
  • Epilepsy Research
  • Metabolic Brain Imaging

Background:

  • Temporal lobe epilepsy (TLE) is a common epilepsy syndrome.
  • Hippocampal sclerosis (HS) is a frequent finding in TLE, but some patients lack MRI evidence of HS (HS-ve).
  • Understanding metabolic patterns in HS-ve TLE is crucial for diagnosis and treatment.

Purpose of the Study:

  • To investigate differences in 2-deoxy-2-[F-18]fluoro-D-glucose (FDG)-positron emission tomography (PET) hypometabolism patterns between HS-ve TLE and typical mesial TLE with HS (HS+ve).
  • To test the hypothesis that HS-ve TLE exhibits lateral temporal neocortical hypometabolism, contrasting with the mesial focus in HS+ve TLE.

Main Methods:

  • Compared FDG-PET scans of 28 HS-ve TLE patients and 24 HS+ve TLE patients with 20 healthy controls.
  • Utilized statistical parametric mapping (SPM) for group comparisons.
  • Patients were selected based on well-lateralized electroencephalogram (EEG) findings.

Main Results:

  • Both HS-ve and HS+ve TLE groups demonstrated lateralized temporal hypometabolism compared to controls.
  • HS+ve TLE showed hypometabolism predominantly in antero-infero-mesial regions.
  • HS-ve TLE exhibited greater hypometabolism in inferolateral temporal regions compared to HS+ve TLE.

Conclusions:

  • FDG-PET reveals distinct hypometabolism patterns in TLE based on MRI findings of HS.
  • These findings support the hypothesis of lateral neocortical involvement in 'MRI-negative PET-positive TLE.'
  • Differentiates metabolic signatures in TLE subtypes, aiding in understanding disease heterogeneity.

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