Document Detail


Source propagation of interictal spikes in temporal lobe epilepsy. Correlations between spike dipole modelling and [18F]fluorodeoxyglucose PET data.
MedLine Citation:
PMID:  8800934     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Source localization methods were applied to interictal spikes from scalp EEGs and correlated with metabolic (PET scan) data in eight patients suffering from drug-resistant temporal lobe epilepsy (TLE). Dipolar sources, [18F]fluorodeoxyglucose (18FDG)-PET data and anatomical images (MRI) were projected into the same three-dimensional coordinates system. Averaged spikes were adequately modelled by two or three dipolar sources with different onset time of activation but overlapping activity (mean residual variance 3.4 +/- 2.1%). Although, in all patients, spike modelling demonstrated dipolar sources in both mesial and lateral temporal cortex, dipole propagation was consistent with the early involvement of only one of these two areas (mesio-temporal, five patients; lateral and polar neocortex, three patients). Six patients showed a unilateral interictal decrease in glucose uptake, as measured with 18FDG-PET, in the temporal lobe ipsilateral to the EEG spike focus. Temporal hypometabolism was bilateral in one patient and absent in the remaining case. When projected onto PET-scan slices, the dipolar sources of these patients were always included within the hypometabolic area. However, within the hypometabolic zone, the decrease in glucose uptake was not found to be more pronounced in regions containing dipoles. Therefore the spatio-temporal spread of neuronal hyperactivity underlying interictal spiking suggests the presence of preferential epileptogenic networks inside the hypometabolic temporal lobe. Fusion of bioelectric, metabolic and anatomical data proves to be a convenient way of summarizing multimodal information from non-invasive investigations in TLE patients entering an epilepsy surgery programme, and suggests that both interictal spike dipole modelling and 18FDG-PET data might be useful, as a complement to ictal electro-clinical data, in the presurgical evaluation of such patients.
Authors:
I Merlet; L Garcia-Larrea; M C Grégoire; F Lavenne; F Mauguière
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Brain : a journal of neurology     Volume:  119 ( Pt 2)     ISSN:  0006-8950     ISO Abbreviation:  Brain     Publication Date:  1996 Apr 
Date Detail:
Created Date:  1996-10-01     Completed Date:  1996-10-01     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0372537     Medline TA:  Brain     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  377-92     Citation Subset:  AIM; IM    
Affiliation:
Claude Bernard University Lyon I, Department of Functional Neurology and Epileptology, France.
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MeSH Terms
Descriptor/Qualifier:
Adult
Brain / physiopathology,  radionuclide imaging*
Brain Mapping
Deoxyglucose / analogs & derivatives,  diagnostic use
Electroencephalography*
Epilepsy, Temporal Lobe / physiopathology*,  radionuclide imaging
Female
Fluorodeoxyglucose F18
Humans
Male
Middle Aged
Tomography, Emission-Computed
Chemical
Reg. No./Substance:
154-17-6/Deoxyglucose; 63503-12-8/Fluorodeoxyglucose F18

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