title: Gender-specific differences of hypometabolism in mTLE: implication for cognitive impairments.
abstract: OBJECTIVE
  To determine gender differences of hypometabolism and their implications for cognitive impairment in patients with medically refractory mesial temporal lobe epilepsy (mTLE).
  
  
  METHODS
  Regional cerebral glucose metabolism (rCMRGlu) was studied in 42 patients (21 male, 21 female) with either left- or right-sided mTLE (22 left, 20 right) and in 12 gender- and age-matched healthy controls during resting wakefulness and in 12 sex- and age-matched healthy controls. Clinical characteristics were balanced across the patient subgroups. All patients were subjected to neuropsychological assessment: 41 patients had histologic changes of definite or probable hippocampal sclerosis.
  
  
  RESULTS
  Data analysis based on pixel-by-pixel comparisons and on a laterality index of regions of interest (ROIs) showed significant depressions of the mean rCMRGlu extending beyond the mesiotemporal region and temporolateral cortex to extratemporal regions including the frontoorbital and insular cortex in mTLE patients. Extramesiotemporal hypometabolism prevailed in the male patients. Metabolic asymmetry in temporal and frontal regions was related to performance in the Trail-Making Test and WAIS-R subitems.
  
  
  CONCLUSIONS
  Our data showed a gender-specific predominance of extramesiotemporal hypometabolism in male patients with mTLE related to abnormalities of temporal and frontal lobe functions.
authors.affiliation: Department of Neurology, University-Hospital Düsseldorf, Moorenstrasse 5, D-40225 Düsseldorf, Germany.
authors.forename: Janpeter
authors.initials: J
authors.lastname: Nickel
authors.forename: Hennric
authors.initials: H
authors.lastname: Jokeit
authors.forename: Gilbert
authors.initials: G
authors.lastname: Wunderlich
authors.forename: Alois
authors.initials: A
authors.lastname: Ebner
authors.forename: Otto W
authors.initials: OW
authors.lastname: Witte
authors.forename: Rüdiger J
authors.initials: RJ
authors.lastname: Seitz
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000378:metabolism*; D002540:Cerebral Cortex / Q000000981:diagnostic imaging / Q000503:physiopathology; D003072:Cognition Disorders / Q000000981:diagnostic imaging* / Q000503:physiopathology; D004734:Energy Metabolism / Q000502:physiology*; D004833:Epilepsy, Temporal Lobe / Q000000981:diagnostic imaging* / Q000503:physiopathology; D005260:Female; D019788:Fluorodeoxyglucose F18; D006624:Hippocampus / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D012016:Reference Values; D012598:Sclerosis; D012737:Sex Factors; D013702:Temporal Lobe / Q000000981:diagnostic imaging / Q000503:physiopathology; D014055:Tomography, Emission-Computed
chemical_list: D001786:Blood Glucose; D019788:Fluorodeoxyglucose F18