Journal article
Perfusion network shift during seizures in medial temporal lobe epilepsy
PloS one, Vol.8(1), pp.e53204-e53204
2013
DOI: 10.1371/journal.pone.0053204
PMCID: PMC3544909
PMID: 23341932
Abstract
Medial temporal lobe epilepsy (MTLE) is associated with limbic atrophy involving the hippocampus, peri-hippocampal and extra-temporal structures. While MTLE is related to static structural limbic compromise, it is unknown whether the limbic system undergoes dynamic regional perfusion network alterations during seizures. In this study, we aimed to investigate state specific (i.e. ictal versus interictal) perfusional limbic networks in patients with MTLE.
We studied clinical information and single photon emission computed tomography (SPECT) images obtained with intravenous infusion of the radioactive tracer Technetium- Tc 99 m Hexamethylpropyleneamine Oxime (Tc-99 m HMPAO) during ictal and interictal state confirmed by video-electroencephalography (VEEG) in 20 patients with unilateral MTLE (12 left and 8 right MTLE). Pair-wise voxel-based analyses were used to define global changes in tracer between states. Regional tracer uptake was calculated and state specific adjacency matrices were constructed based on regional correlation of uptake across subjects. Graph theoretical measures were applied to investigate global and regional state specific network reconfigurations.
A significant increase in tracer uptake was observed during the ictal state in the medial temporal region, cerebellum, thalamus, insula and putamen. From network analyses, we observed a relative decreased correlation between the epileptogenic temporal region and remaining cortex during the interictal state, followed by a surge of cross-correlated perfusion in epileptogenic temporal-limbic structures during a seizure, corresponding to local network integration.
These results suggest that MTLE is associated with a state specific perfusion and possibly functional organization consisting of a surge of limbic cross-correlated tracer uptake during a seizure, with a relative disconnection of the epileptogenic temporal lobe in the interictal period. This pattern of state specific shift in metabolic networks in MTLE may improve the understanding of epileptogenesis and neuropsychological impairments associated with MTLE.
Details
- Title: Subtitle
- Perfusion network shift during seizures in medial temporal lobe epilepsy
- Creators
- Karen M Sequeira - Comprehensive Epilepsy Center, Division of Neurology, Department of Neurosciences, Medical University of South Carolina, Charleston, SC, USAAli TabeshRup K SainjuStacia M DeSantisThomas NaselarisJane E JosephMark A AhlmanKenneth M SpicerSteve S GlazierJonathan C EdwardsLeonardo Bonilha
- Resource Type
- Journal article
- Publication Details
- PloS one, Vol.8(1), pp.e53204-e53204
- DOI
- 10.1371/journal.pone.0053204
- PMID
- 23341932
- PMCID
- PMC3544909
- NLM abbreviation
- PLoS One
- ISSN
- 1932-6203
- eISSN
- 1932-6203
- Publisher
- Public Library of Science; United States
- Grant note
- UL1 TR000062 / NCATS NIH HHS UL1 RR029882 / NCRR NIH HHS
- Language
- English
- Date published
- 2013
- Academic Unit
- Neurology
- Record Identifier
- 9984020643102771
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