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Brain, Vol. 119, No. 5, 1677-1687, 1996
© 1996 Guarantors of Brain

research-article

Cerebral benzodiazepine receptors in hippocampal sclerosis

An objective in vivo analysis

M. I. Koepp1,2, M. P. Richardson1,2, D. I. Brooks1, J. B. Poline1, W. Van Paesschen2, K. J. Friston1 and J. S. Duncan1,2,

1MRC Cyclotron Unit, Hammersmith Hospital London, UK 2Epilepsy Research Group, Institute of Neurology London, UK

Correspondence to: J. S. Duncan, Epilepsy Research Group, Institute of Neurology, Queen Square, London WCIN 3BG, UK

We objectively delineated the extent of abnormalities in central benzodiazepine receptor (cBZR) binding using [11C]flumazenil (FMZ)-PET and high resolution volumetric MRI in 12 patients with mesial temporal lobe epilepsy (mTLE) associated with unilateral hippocampal sclerosis, who underwent presurgical evaluation and subsequent temporal lobe surgery. We compared parametric 3D-images of regional cerebral [11C]FMZ volume of distribution (Vd) obtained from individuals and groups of patients with [11C]FMZ-Vd from a group of 17 healthy controls using statistical parametric mapping (SPM). The [12C]FMZ-Vd was significantly reduced (P < 0.001) in the affected hippocampus in the group of 12 patients with unilateral hippocampal sclerosis. Analysis of individual patients reflected the group finding and there was no significant abnormality of cBZR binding outside the hippocampus in any patient. We conclude that SPM is an useful objective method for detecting changes in regional cerebral [11C]FMZ binding and that in patients with mTLE and unilateral hippocampal sclerosis reduction of cBZR binding is restricted to the area of hippocampal sclerosis with no abnormalities being detected in the temporal neocortex or elsewhere in the neocortex.

Received November 27, 1995. Revised February 20, 1996. Accepted June 14, 1996.


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