Regional cerebral glucose metabolism in epilepsies with continuous spikes and waves during sleep.
BACKGROUND
Epileptic syndromes with continuous spikes and waves during sleep (CSWS) represent a wide spectrum of epileptic conditions associated with cognitive dysfunctions that have the EEG pattern of CSWS as a common feature. Reported are the results of voxel-based analyses of brain glucose metabolism performed in a group of 18 children with CSWS.


METHODS
Voxel-based analyses of cerebral glucose metabolism were performed using statistical parametric mapping (SPM). First, each patient was compared with a control group and the influence of age, epileptic activity, and corticosteroid treatment on metabolic abnormalities was studied. Also, disease-related changes in the contribution of a brain area to the level of metabolic activity in another brain area were investigated using pathophysiologic interactions in groups of patients compared with the control group.


RESULTS
Individual SPM analyses identified three metabolic patterns: association of hypermetabolic and hypometabolic areas, hypometabolic areas only, and normal pattern. Age and intensity of awake interictal spiking did not significantly differ in patients showing focal hypermetabolism compared with the other ones. Treatment with corticosteroids was associated with absence of focal hypermetabolism. In the group of patients with hypermetabolic areas, analyses of pathophysiologic interactions showed disease-related altered functional connectivity between the parietal and frontal cortices.


CONCLUSIONS
Cerebral metabolic patterns are heterogeneous among patients with CSWS. This metabolic heterogeneity could be related to the use of corticosteroid treatment before PET. The parietofrontal altered connectivity observed in patients with hypermetabolism is interpreted as a phenomenon of remote inhibition of the frontal lobes induced by highly epileptogenic and hypermetabolic posterior cortex.
De Tiège
X
X
PET/Biomedical Cyclotron Unit, ULB-Hôpital Erasme, 808 route de Lennik, 1070 Brussels, Belgium. xdetiege@ulb.ac.be
Goldman
S
S
Laureys
S
S
Verheulpen
D
D
Chiron
C
C
Wetzburger
C
C
Paquier
P
P
Chaigne
D
D
Poznanski
N
N
Jambaqué
I
I
Hirsch
E
E
Dulac
O
O
Van Bogaert
P
P
D001921:Brain / Q000000981:diagnostic imaging / Q000378:metabolism*; D002648:Child; D002675:Child, Preschool; D004569:Electroencephalography; D004827:Epilepsy / Q000000981:diagnostic imaging / Q000378:metabolism* / Q000503:physiopathology; D005260:Female; D019788:Fluorodeoxyglucose F18; D005625:Frontal Lobe / Q000000981:diagnostic imaging / Q000378:metabolism / Q000503:physiopathology; D005947:Glucose / Q000378:metabolism*; D006801:Humans; D008297:Male; D009928:Organ Specificity; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D020919:Sleep Disorders, Intrinsic / Q000000981:diagnostic imaging / Q000378:metabolism* / Q000503:physiopathology
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D005947:Glucose