Basal ganglia involvement in temporal lobe epilepsy: a functional and morphologic study.
OBJECTIVE
A decrease of [(18)F]fluoro-l-dopa uptake in basal ganglia was recently reported in medically refractory epilepsy. The purpose of this study was to assess the involvement of dopaminergic neurotransmission in refractory temporal lobe epilepsy (TLE) and its relationship to glucose metabolism and morphologic changes.


METHODS
Twelve TLE patients were studied using [(18)F]fluorodeoxyglucose PET, [(18)F]fluoro-l-dopa PET, and MRI and compared with healthy control volunteers. Morphologic cerebral changes were assessed using voxel-based morphometry. Student t test statistical maps of functional and morphologic differences between patients and controls were obtained using a general linear model.


RESULTS
In TLE patients, [(18)F]fluoro-l-dopa uptake was reduced to the same extent in caudate and putamen in both cerebral hemispheres as well as in the substantia nigra (SN). These dopaminergic functional alterations occurred without any glucose metabolism changes in these areas. The only mild morphologic abnormality was found in striatal regions without any changes in the SN.


CONCLUSIONS
The present study provides support for dopaminergic neurotransmission involvement in temporal lobe epilepsy. The discrepancies between gray matter volume atrophy and the pattern of [(18)F]fluoro-l-dopa suggest that basal ganglia involvement is not related to structural subcortical abnormalities. A functional decrease can be ruled out because there was no change of the glycolytic pathway metabolism in these areas.
Bouilleret
V
V
Service Hospitalier Frédéric Joliot, I2BM/DSV, CEA, 4, place du Général Leclerc, F-91406 Orsay, France.
Semah
F
F
Chassoux
F
F
Mantzaridez
M
M
Biraben
A
A
Trebossen
R
R
Ribeiro
M-J
MJ
D000293:Adolescent; D000328:Adult; D001479:Basal Ganglia / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000503:physiopathology*; D001480:Basal Ganglia Diseases / Q000000981:diagnostic imaging* / Q000209:etiology* / Q000503:physiopathology; D004295:Dihydroxyphenylalanine / Q000031:analogs & derivatives; D004298:Dopamine / Q000378:metabolism; D015536:Down-Regulation / Q000502:physiology; D004734:Energy Metabolism / Q000502:physiology; D004833:Epilepsy, Temporal Lobe / Q000150:complications* / Q000000981:diagnostic imaging* / Q000503:physiopathology; D005260:Female; D019788:Fluorodeoxyglucose F18; D005947:Glucose / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D017072:Neostriatum / Q000000981:diagnostic imaging / Q000378:metabolism / Q000503:physiopathology; D009434:Neural Pathways / Q000000981:diagnostic imaging / Q000378:metabolism / Q000503:physiopathology; D049268:Positron-Emission Tomography; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D013378:Substantia Nigra / Q000000981:diagnostic imaging / Q000378:metabolism / Q000503:physiopathology
D019788:Fluorodeoxyglucose F18; C043437:fluorodopa F 18; D004295:Dihydroxyphenylalanine; D005947:Glucose; D004298:Dopamine