Annals of clinical and translational neurology · 2022
Patterns of hypometabolism in frontal lobe epilepsy originating in different frontal regions.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод пока не подготовлен
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Zhao Zexian, Li Hong, Wang Shan, Chen Cong, He Chenmin, Hu Lingli, Zheng Zhe, Zhu Junming, Ding Meiping, Wang Shuang, Ding Yao
Аннотация
OBJECTIVES: Analysis of FDG-PET imaging commonly shows that hypometabolism extends into extra-epileptogenic zones (extra-EZ). This study investigates the distribution patterns of hypometabolism in frontal lobe epilepsy (FLE) originating in different frontal regions.
METHODS: Sixty-four patients with FLE were grouped by EZ localization according to Brodmann areas (BAs): Group 1 (the frontal motor and premotor area), BAs 4, 6, and 8; Group 2 (the inferior frontal gyrus and opercular area), BAs 44, 45, and 47; Group 3 (the dorsal prefrontal area), BAs 9, 10, 11, and 46; and Group 4 (the medial frontal and anterior cingulate gyrus), BAs 32 and 24. Regions of extra-EZ hypometabolism were statistically analyzed between FLE groups and healthy controls. Correlation analysis was performed to identify relationships between the intensity of hypometabolism and clinical characteristics.
RESULTS: Significant hypometabolism in the ipsilateral (Groups 1 and 4) or bilateral (Groups 2 and 3) anterior insulae was found. Groups 1 and 4 presented with limited distribution of extra-EZ hypometabolism, whereas Groups 2 and 3 showed widely distributed extra-EZ hypometabolism in the rectus gyrus, cingulate gyrus, and other regions. Additionally, the intensity of hypometabolism was correlated with epilepsy duration in Groups 2 and 3.
CONCLUSIONS: All FLE groups showed hypometabolism in the anterior insula. In addition, distinct patterns of extra-EZ hypometabolism were identified for each FLE group. This quantitative FDG-PET analysis expanded our understanding of the topography of epileptic networks and can guide EZ localization in the future.
METHODS: Sixty-four patients with FLE were grouped by EZ localization according to Brodmann areas (BAs): Group 1 (the frontal motor and premotor area), BAs 4, 6, and 8; Group 2 (the inferior frontal gyrus and opercular area), BAs 44, 45, and 47; Group 3 (the dorsal prefrontal area), BAs 9, 10, 11, and 46; and Group 4 (the medial frontal and anterior cingulate gyrus), BAs 32 and 24. Regions of extra-EZ hypometabolism were statistically analyzed between FLE groups and healthy controls. Correlation analysis was performed to identify relationships between the intensity of hypometabolism and clinical characteristics.
RESULTS: Significant hypometabolism in the ipsilateral (Groups 1 and 4) or bilateral (Groups 2 and 3) anterior insulae was found. Groups 1 and 4 presented with limited distribution of extra-EZ hypometabolism, whereas Groups 2 and 3 showed widely distributed extra-EZ hypometabolism in the rectus gyrus, cingulate gyrus, and other regions. Additionally, the intensity of hypometabolism was correlated with epilepsy duration in Groups 2 and 3.
CONCLUSIONS: All FLE groups showed hypometabolism in the anterior insula. In addition, distinct patterns of extra-EZ hypometabolism were identified for each FLE group. This quantitative FDG-PET analysis expanded our understanding of the topography of epileptic networks and can guide EZ localization in the future.