Statistical voxel-wise analysis of ictal SPECT reveals pattern of abnormal perfusion in patients with temporal lobe epilepsy.
OBJECTIVE
To investigate the pattern of perfusion abnormalities in ictal and interictal brain perfusion SPECT images (BSI) from patients with temporal lobe epilepsy (TLE).


METHODS
It was acquired interictal and ictal BSI from 24 patients with refractory TLE. BSIs were analyzed by visual inspection and statistical parametric mapping (SPM2). Statistical analysis compared the patients group to a control group of 50 volunteers. The images from patients with left-TLE were left-right flipped.


RESULTS
It was not observed significant perfusional differences in interictal scans with SPM. Ictal BSI in SPM analysis revealed hyperperfusion within ipsilateral temporal lobe (epileptogenic focus) and also contralateral parieto-occipital region, ipsilateral posterior cingulate gyrus, occipital lobes and ipsilateral basal ganglia. Ictal BSI also showed areas of hypoperfusion.


CONCLUSIONS
In a group analysis of ictal BSI of patients with TLE, voxel-wise analysis detects a network of distant regions of perfusional alteration which may play active role in seizure genesis and propagation.
Amorim
Bárbara Juarez
BJ
Department of Radiology, Faculdade de Ciências Médicas, UNICAMP, Campinas, Brazil. juarezbarbara@hotmail.com
Etchebehere
Elba Cristina Sá de Camargo
EC
Camargo
Edwaldo Eduardo
EE
Rio
Pablo Augusto
PA
Bonilha
Leonardo
L
Rorden
Chris
C
Li
Li Min
LM
Cendes
Fernando
F
D000293:Adolescent; D000328:Adult; D001921:Brain / Q000098:blood supply* / Q000000981:diagnostic imaging; D016022:Case-Control Studies; D002560:Cerebrovascular Circulation / Q000502:physiology; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D003627:Data Interpretation, Statistical; D004833:Epilepsy, Temporal Lobe / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015899:Tomography, Emission-Computed, Single-Photon