title: Cerebral regional hypometabolism caused by propofol-induced sedation in children with severe myoclonic epilepsy: a study using fluorodeoxyglucose positron emission tomography and statistical parametric mapping.
abstract: Cerebral positron emission tomography (PET) in children often requires sedation. This study evaluated sedation-associated effects on cerebral glucose metabolism in 30 children with severe myoclonic epilepsy as investigated by cerebral (18)F-fluorodeoxyglucose (FDG)-PET. Prior to the PET acquisition, 24 children underwent propofol sedation. Pixel-based t-statistics were calculated using statistical parametric mapping (SPM99) for comparisons of the patients' PET scans with both a healthy adult control group and an age-matched child intra-group control. In both analyses, statistically significant hypometabolic areas were found in the medial parieto-occipital cortex bilaterally, including the lingual gyrus, cuneus, posterior cingulate and middle occipital gyrus in all sedated children. All these localizations correlated in a covariate analysis with the injected dose of propofol (P<0.01, corrected). The bilateral parieto-occipital hypometabolism is likely to be a sedation-specific effect and should be taken into account when evaluating cerebral FDG-PET scans in sedated children.
authors.affiliation: Department of Radiology, Division of Nuclear Medicine, University Hospital Freiburg, Hugstetterstr. 55, D-79106, Freiburg, Germany. freimut.juengling@insel.ch
authors.forename: Freimut D
authors.initials: FD
authors.lastname: Juengling
authors.forename: Jan
authors.initials: J
authors.lastname: Kassubek
authors.forename: Heike
authors.initials: H
authors.lastname: Martens-Le Bouar
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Reinhardt
authors.forename: Thomas
authors.initials: T
authors.lastname: Krause
authors.forename: Egbert U
authors.initials: EU
authors.lastname: Nitzsche
authors.forename: Ernst
authors.initials: E
authors.lastname: Moser
authors.forename: Rudolf
authors.initials: R
authors.lastname: Korinthenberg
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000465:Algorithms; D000927:Anticonvulsants / Q000494:pharmacology*; D001931:Brain Mapping; D002540:Cerebral Cortex / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D004831:Epilepsies, Myoclonic / Q000378:metabolism*; D005260:Female; D019788:Fluorodeoxyglucose F18; D005947:Glucose / Q000378:metabolism*; D006801:Humans; D008297:Male; D016555:Matched-Pair Analysis; D008875:Middle Aged; D009778:Occipital Lobe / Q000000981:diagnostic imaging / Q000378:metabolism; D015742:Propofol / Q000494:pharmacology*; D013702:Temporal Lobe / Q000000981:diagnostic imaging / Q000378:metabolism; D014055:Tomography, Emission-Computed
chemical_list: D000927:Anticonvulsants; D019788:Fluorodeoxyglucose F18; D005947:Glucose; D015742:Propofol