title: Combined18F-FDG-PET and diffusion tensor imaging in mesial temporal lobe epilepsy with hippocampal sclerosis.
abstract: Several studies using18F-fluorodeoxyglucose positron emission tomography (18F-FDG-PET) or diffusion tensor imaging (DTI) have found both temporal and extratemporal abnormalities in patients with mesial temporal lobe epilepsy with ipsilateral hippocampal sclerosis (MTLE-HS), but data are lacking about the findings of both techniques in the same patients. We aimed to determine whether the extent of18F-FDG-PET hypometabolism is related to DTI abnormalities.
  
  
  
  Twenty-one patients with MTLE-HS underwent comprehensive preoperative evaluation; 18 (86%) of these underwent epilepsy surgery. We analyzed and compared the pattern of white matter (WM) alterations on DTI and cortical hypometabolism on18F-FDG-PET.
  
  
  
  We found widespread temporal and extratemporal18F-FDG-PET and DTI abnormalities. Patterns of WM abnormalities and cortical glucose hypometabolism involved similar brain regions, being more extensive in the left than the right MTLE-HS. We classified patients into three groups according to temporal18F-FDG-PET patterns: hypometabolism restricted to the anterior third (n = 7), hypometabolism extending to the middle third (n = 7), and hypometabolism extending to the posterior third (n = 7). Patients with anterior temporal hypometabolism showed DTI abnormalities in anterior association and commissural tracts while patients with posterior hypometabolism showed WM alterations in anterior and posterior tracts.
  
  
  
  Patients with MTLE-HS have widespread metabolic and microstructural abnormalities that involve similar regions. The distribution patterns of these gray and white matter abnormalities differ between patients with left or right MTLE, but also with the extent of the18F-FDG-PET hypometabolism along the epileptogenic temporal lobe. These findings suggest a variable network involvement among patients with MTLE-HS.
authors.affiliation: Hospital Clínic, Epilepsy Program, Department of Neurology, Neuroscience Institute, CP 08036, Barcelona, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Aparicio
authors.affiliation: Hospital Clínic, Epilepsy Program, Department of Neurology, Neuroscience Institute, CP 08036, Barcelona, Spain; Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), CP 08036, Barcelona, Spain.
authors.forename: Mar
authors.initials: M
authors.lastname: Carreño
authors.affiliation: Hospital Clínic, Epilepsy Program, Department of Radiology, CDIC, CP 08036, Barcelona, Spain; Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), CP 08036, Barcelona, Spain.
authors.forename: Núria
authors.initials: N
authors.lastname: Bargalló
authors.affiliation: Hospital Clínic, Epilepsy Program, Department of Nuclear Medicine, CDIC, CP 08036, Barcelona, Spain; Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), CP 08036, Barcelona, Spain.
authors.forename: Xavier
authors.initials: X
authors.lastname: Setoain
authors.affiliation: Nuclear Medicine Department, Hospital Universitari Son Espases, Instituto de Investigación Sanitaria de Palma, CP 07010, Palma, Spain.
authors.forename: Sebastià
authors.initials: S
authors.lastname: Rubí
authors.affiliation: Hospital Clínic, Epilepsy Program, Department of Neurosurgery, Neuroscience Institute, CP 08036, Barcelona, Spain.
authors.forename: Jordi
authors.initials: J
authors.lastname: Rumià
authors.affiliation: BarcelonaBeta Brain Research Center, Pasqual Maragall Foundation, CP 08003, Barcelona, Spain.
authors.forename: Carles
authors.initials: C
authors.lastname: Falcón
authors.affiliation: Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), CP 08036, Barcelona, Spain.
authors.forename: Anna
authors.initials: A
authors.lastname: Calvo
authors.affiliation: Grupo de Imagen Biomédica de la Universidad de Barcelona (GIB-UB), Biomedical Research Networking Center in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), CP 08036, Barcelona, Spain; Department of Physiological Sciences I - Biophysics and Bioengineering Unit, University of Barcelona, CP, O8036, Barcelona, Spain.
authors.forename: Berta
authors.initials: B
authors.lastname: Martí-Fuster
authors.affiliation: Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Nelly
authors.initials: N
authors.lastname: Padilla
authors.affiliation: Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), CP 08036, Barcelona, Spain; Hospital Clínic, Epilepsy Program, Department of Neuropsychology, Neuroscience Institute, CP 08036, Barcelona, Spain.
authors.forename: Teresa
authors.initials: T
authors.lastname: Boget
authors.affiliation: Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), CP 08036, Barcelona, Spain; Hospital Clínic, Epilepsy Program, Department of Psychiatry, Neuroscience Institute, CP 08036, Barcelona, Spain.
authors.forename: Luís
authors.initials: L
authors.lastname: Pintor
authors.affiliation: Hospital Clínic, Epilepsy Program, Department of Neurology, Neuroscience Institute, CP 08036, Barcelona, Spain; Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), CP 08036, Barcelona, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Donaire
mesh_terms: D000293:Adolescent; D000328:Adult; D056324:Diffusion Tensor Imaging / Q000379:methods*; D004833:Epilepsy, Temporal Lobe / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology; D005260:Female; D019788:Fluorodeoxyglucose F18; D066128:Gray Matter / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology; D006624:Hippocampus / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D049268:Positron-Emission Tomography / Q000379:methods*; D012598:Sclerosis / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology; D066127:White Matter / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology; D055815:Young Adult
chemical_list: D019788:Fluorodeoxyglucose F18
keywords: DTI; Hippocampus; MTLE; Nerve net; Positron emission tomography