Document Detail

Localizing value of alpha-methyl-L-tryptophan PET in intractable epilepsy of neocortical origin.
MedLine Citation:
PMID:  11706103     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: [(11)C] alpha-methyl-L-tryptophan (alpha-MTrp) has been developed as a tracer for the study of the synthesis of serotonin in the brain with PET. However, it has been shown that in pathologic conditions the tracer may reflect the activation of kynurenine metabolism. Increased levels of serotonin and quinolinic acid have been described in resected epileptogenic cortex, raising the possibility that alpha-MTrp can localize seizure foci in patients with intractable partial epilepsy. The authors assessed the uptake of alpha-MTrp in 18 patients (11 men, mean +/- SD age 27.1 +/- 10.1 years, range 13 to 54) with intractable partial epilepsy to correlate the PET findings with the epileptogenic area defined by electroclinical and neuroimaging data. METHOD: Seven patients with cortical dysplasia (CD) and 11 with partial epilepsy in which conventional MRI and fluorine-18-deoxyglucose ((18)FDG)-PET studies failed to detect any abnormality were studied. All underwent scalp EEG monitoring during the PET scan to exclude ictal events and estimate the interictal epileptic activity. RESULTS: In seven patients (39%; CD four and cryptogenic partial epilepsy three), PET showed focal increased uptake of alpha-MTrp corresponding to the epileptogenic area. alpha-MTrp uptake in the epileptic focus correlated with the frequency of interictal spikes (r = 0.7, p < 0.05). CONCLUSIONS: alpha-MTrp-PET may be of value in the localization of the epileptogenic area not only in patients with visible dysplastic lesions, but also in those with cryptogenic partial epilepsy.
M Fedi; D Reutens; H Okazawa; F Andermann; W Boling; F Dubeau; C White; A Nakai; D W Gross; E Andermann; M Diksic
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Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Neurology     Volume:  57     ISSN:  0028-3878     ISO Abbreviation:  Neurology     Publication Date:  2001 Nov 
Date Detail:
Created Date:  2001-11-13     Completed Date:  2001-12-18     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0401060     Medline TA:  Neurology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1629-36     Citation Subset:  AIM; IM    
Department of Neurology, McGill University, Canada.
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MeSH Terms
Carbon Radioisotopes / diagnostic use
Epilepsies, Partial / pathology*,  radionuclide imaging*,  surgery
Fluorodeoxyglucose F18 / diagnostic use
Middle Aged
Neocortex / pathology*,  radionuclide imaging
Radiopharmaceuticals / diagnostic use
Tomography, Emission-Computed*
Tomography, Emission-Computed, Single-Photon
Tryptophan / analogs & derivatives*,  diagnostic use*
Grant Support
Reg. No./Substance:
0/Carbon Radioisotopes; 0/Radiopharmaceuticals; 13510-08-2/alpha-methyltryptophan; 63503-12-8/Fluorodeoxyglucose F18; 73-22-3/Tryptophan

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