Advertisement

Dynamic perfusion patterns in temporal lobe epilepsy

  • Patrick Dupont
  • John J. ZaknunEmail author
  • Alex Maes
  • Supatporn Tepmongkol
  • Silvia Vasquez
  • C. S. Bal
  • Wim Van Paesschen
  • Silvina Carpintiero
  • Chaichon Locharernkul
  • Maurizio Dondi
Original Article

Abstract

Purpose

To investigate dynamic ictal perfusion changes during temporal lobe epilepsy (TLE).

Methods

We investigated 37 patients with TLE by ictal and interictal SPECT. All ictal injections were performed within 60 s of seizure onset. Statistical parametric mapping was used to analyse brain perfusion changes and temporal relationships with injection time and seizure duration as covariates.

Results

The analysis revealed significant ictal hyperperfusion in the ipsilateral temporal lobe extending to subcortical regions. Hypoperfusion was observed in large extratemporal areas. There were also significant dynamic changes in several extratemporal regions: ipsilateral orbitofrontal and bilateral superior frontal gyri and the contralateral cerebellum and ipsilateral striatum.

Conclusion

The study demonstrated early dynamic perfusion changes in extratemporal regions probably involved in both propagation of epileptic activity and initiation of inhibitory mechanisms.

Keywords

Perfusion imaging Network Surround inhibition Seizure cessation 

Notes

Acknowledgments

This work was conducted within the framework of a Coordinated Research Project (CRP E1.30.21) of the International Atomic Energy Agency (IAEA) and supported by IAEA contract BEL-12546.

References

  1. 1.
    French JA, Williamson PD, Thadani VM, Darcey TM, Mattson RH, Spencer SS, et al. Characteristics of medial temporal lobe epilepsy: I. Results of history and physical examination. Ann Neurol 1993;34:774–80.PubMedCrossRefGoogle Scholar
  2. 2.
    Williamson PD, French JA, Thadani VM, Kim JH, Novelly RA, Spencer SS, et al. Characteristics of medial temporal lobe epilepsy: II. Interictal and ictal scalp electroencephalography, neuropsychological testing, neuroimaging, surgical results, and pathology. Ann Neurol 1993;34:781–7.PubMedCrossRefGoogle Scholar
  3. 3.
    Schwartz TH, Bonhoeffer T. In vivo optical mapping of epileptic foci and surround inhibition in ferret cerebral cortex. Nat Med 2001;7:1063–7.PubMedCrossRefGoogle Scholar
  4. 4.
    Zaknun JJ, Bal C, Maes A, Tepmongkol S, Vazquez S, Dupont P, et al. Comparative analysis of MR imaging, ictal SPECT and EEG in temporal lobe epilepsy: a prospective IAEA multicenter study. Eur J Nucl Med Mol Imaging 2008;35:107–15.PubMedCrossRefGoogle Scholar
  5. 5.
    Duncan R, Patterson J, Roberts R, Hadley DM, Bone I. Ictal/postictal SPECT in the pre-surgical localisation of complex partial seizures. J Neurol Neurosurg Psychiatry 1993;56:141–8.PubMedCrossRefGoogle Scholar
  6. 6.
    Newton MR, Berkovic SF, Austin MC, Rowe CC, McKay WJ, Bladin PF. SPECT in the localisation of extratemporal and temporal seizure foci. J Neurol Neurosurg Psychiatry 1995;59:26–30.PubMedCrossRefGoogle Scholar
  7. 7.
    Kim JH, Im KC, Kim JS, Lee SA, Lee JK, Khang SK, et al. Ictal hyperperfusion patterns in relation to ictal scalp EEG patterns in patients with unilateral hippocampal sclerosis: a SPECT study. Epilepsia 2007;48:270–7.PubMedCrossRefGoogle Scholar
  8. 8.
    Van Paesschen W, Dupont P, Van Driel G, Van Billoen H, Maes A. SPECT perfusion changes during complex partial seizures in patients with hippocampal sclerosis. Brain 2003;126:1103–11.PubMedCrossRefGoogle Scholar
  9. 9.
    Blumenfeld H, McNally KA, Vanderhill SD, et al. Positive and negative network correlations in temporal lobe epilepsy. Cereb Cortex 2004;14:892–902.PubMedCrossRefGoogle Scholar
  10. 10.
    Tae WS, Joo EY, Kim JH, Han SJ, Suh YL, Kim BT, et al. Cerebral perfusion changes in mesial temporal lobe epilepsy: SPM analysis of ictal and interictal SPECT. Neuroimage 2005;24:101–10.PubMedCrossRefGoogle Scholar
  11. 11.
    Kim BJ, Hong SB, Seo DW. Differences in ictal hyperperfusion of limbic-related structures between mesial temporal and neocortical epilepsy. Epilepsy Res 2008;81:167–75.PubMedCrossRefGoogle Scholar
  12. 12.
    Jackson GD, Berkovic SF, Duncan JS, Connelly A. Optimizing the diagnosis of hippocampal sclerosis using MR imaging. AJNR Am J Neuroradiol 1993;14:753–62.PubMedGoogle Scholar
  13. 13.
    Shin WC, Hong SB, Tae WS, Seo DW, Kim SE. Ictal hyperperfusion of cerebellum and basal ganglia in temporal lobe epilepsy: SPECT subtraction with MRI coregistration. J Nucl Med 2001;42:853–8.PubMedGoogle Scholar
  14. 14.
    Mizobuchi M, Matsuda K, Inoue Y, Sako K, Sumi Y, Chitoku S, et al. Dystonic posturing associated with putaminal hyperperfusion depicted on subtraction SPECT. Epilepsia 2004;45:948–53.PubMedCrossRefGoogle Scholar
  15. 15.
    Guye M, Regis J, Tamura M, Wendling F, McGonigal A, Chauvel P, et al. The role of corticothalamic coupling in human temporal lobe epilepsy. Brain 2006;129:1917–28.PubMedCrossRefGoogle Scholar
  16. 16.
    Nelissen N, Van Paesschen W, Baete K, Van Laere K, Palmini A, Van Billoen H, et al. Correlations of interictal FDG-PET metabolism and ictal SPECT perfusion changes in human temporal lobe epilepsy with hippocampal sclerosis. Neuroimage 2006;32:684–95.PubMedCrossRefGoogle Scholar
  17. 17.
    Cavanna AE, Trimble MR. The precuneus: a review of its functional anatomy and behavioural correlates. Brain 2006;129:564–83.PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  • Patrick Dupont
    • 1
  • John J. Zaknun
    • 2
    • 3
    Email author
  • Alex Maes
    • 1
    • 4
  • Supatporn Tepmongkol
    • 5
  • Silvia Vasquez
    • 6
  • C. S. Bal
    • 7
  • Wim Van Paesschen
    • 1
  • Silvina Carpintiero
    • 6
  • Chaichon Locharernkul
    • 5
  • Maurizio Dondi
    • 2
    • 8
  1. 1.Nuclear Medicine, Medical Imaging Center and NeurologyKU Leuven/UZ GasthuisbergLeuvenBelgium
  2. 2.Nuclear Medicine Section, Division of Human HealthInternational Atomic Energy Agency (IAEA)ViennaAustria
  3. 3.Department of Nuclear MedicineUniversity Hospital of InnsbruckInnsbruckAustria
  4. 4.Nuclear MedicineAZ GroeningeKortrijkBelgium
  5. 5.Nuclear Medicine and NeurologyChulalongkorn UniversityBangkokThailand
  6. 6.Nuclear MedicineFleni Instituto de Investigaciones NeurologicasBuenos AiresArgentina
  7. 7.Nuclear MedicineAll India Institute of Medical SciencesNew DelhiIndia
  8. 8.Nuclear MedicineOspedale MaggioreBolognaItaly

Personalised recommendations