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Perfusion network shift during seizures in medial temporal lobe epilepsy

Karen M Sequeira1, Ali Tabesh, Rup K Sainju

  • 1Comprehensive Epilepsy Center, Division of Neurology, Department of Neurosciences, Medical University of South Carolina, Charleston, SC, USA.

Plos One
|January 24, 2013
PubMed
Abstract

Insights

Medial temporal lobe epilepsy (MTLE) shows dynamic brain network changes. During seizures, limbic structures exhibit increased perfusion, while in the interictal state, the epileptogenic temporal lobe becomes relatively disconnected.

Area of Science:

  • Neuroscience
  • Epilepsy Research
  • Medical Imaging

Background:

  • Medial temporal lobe epilepsy (MTLE) involves structural limbic compromise.
  • Dynamic perfusion network alterations during seizures in MTLE remain unclear.

Purpose of the Study:

  • Investigate state-specific (ictal vs. interictal) perfusion networks in the limbic system of MTLE patients.
  • Understand dynamic functional organization during seizures.

Main Methods:

  • Utilized Technetium-Tc 99 m Hexamethylpropyleneamine Oxime (Tc-99 m HMPAO) SPECT imaging during ictal and interictal states in 20 MTLE patients.
  • Performed voxel-based analyses and constructed state-specific adjacency matrices based on regional tracer uptake correlations.
  • Applied graph theoretical measures to analyze network reconfigurations.

Main Results:

  • Observed increased tracer uptake in medial temporal regions, cerebellum, thalamus, insula, and putamen during the ictal state.
  • Detected decreased correlation between the epileptogenic temporal region and the cortex in the interictal state.
  • Found a surge of cross-correlated perfusion in temporal-limbic structures during seizures, indicating local network integration.

Conclusions:

  • MTLE exhibits state-specific perfusion and functional organization with increased limbic perfusion during seizures.
  • A relative disconnection of the epileptogenic temporal lobe occurs in the interictal period.
  • These findings enhance understanding of epileptogenesis and neuropsychological impairments in MTLE.

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