Gender-specific differences of hypometabolism in mTLE: implication for cognitive impairments.
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.
Nickel
Janpeter
J
Department of Neurology, University-Hospital Düsseldorf, Moorenstrasse 5, D-40225 Düsseldorf, Germany.
Jokeit
Hennric
H
Wunderlich
Gilbert
G
Ebner
Alois
A
Witte
Otto W
OW
Seitz
Rüdiger J
RJ
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
D001786:Blood Glucose; D019788:Fluorodeoxyglucose F18