Skip Navigation

This Article
Right arrow FREE Full Text (PDF) Freely available
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrow Search for citing articles in:
ISI Web of Science (43)
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Koepp, M. J.
Right arrow Articles by Duncan, J. S.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Koepp, M. J.
Right arrow Articles by Duncan, J. S.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

Brain, Vol 120, Issue 10 1865-1876, Copyright © 1997 by Oxford University Press

ARTICLES

Regional hippocampal [11C]flumazenil PET in temporal lobe epilepsy with unilateral and bilateral hippocampal sclerosis

MJ Koepp, C Labbe, MP Richardson, DJ Brooks, W Van Paesschen, VJ Cunningham and JS Duncan
MRC Cyclotron Unit Hammersmith Hospital, London, UK.

Using statistical parametric mapping and [11C]flumazenil (FMZ) PET we have previously shown reduction of central benzodiazepine receptor (cBZR) binding restricted to the hippocampus in mesial temporal lobe epilepsy due to unilateral hippocampal sclerosis. However, bilateral hippocampal pathology can be present in up to 50% of patients with mesial temporal lobe epilepsy. Additionally, the limited spatial resolution of PET results in a partial volume effect that affects quantitative analysis of cBZRs and such an effect can mask hippocampal dysfunction. We analysed changes in the [11C]FMZ volume of distribution (FMZ-Vd) before and after correction for partial volume effect in six patients with refractory mesial temporal lobe epilepsy and a quantitative MRI diagnosis of bilateral hippocampal sclerosis, which appeared either symmetrical on MRI (bilateral symmetrical hippocampal sclerosis; three patients) or bilateral but asymmetrical (asymmetrical hippocampal sclerosis; three patients), and in nine patients with refractory mesial temporal lobe epilepsy and unilateral hippocampal sclerosis on MRI than was subsequently histologically verified. Fifteen healthy controls were also studied for comparison. Before correction for partial volume effects, significant unilateral reductions of FMZ-Vd were found in one of the three patients with bilateral symmetrical hippocampal sclerosis, in one of the three asymmetrical hippocampal sclerosis patients and in six of the nine unilateral hippocampal sclerosis patients. No significant bilateral reductions of hippocampal FMZ-Vd were detected. After correction for partial volume effect, all three patients with bilateral symmetrical hippocampal sclerosis showed significant bilateral reductions of FMZ-Vd, and these were asymmetrical in two. All three patients with asymmetrical hippocampal sclerosis and all nine patients with unilateral hippocampal sclerosis on MRI showed unilateral reductions of FMZ-Vd concordant with the side of the EEG focus. In addition one of the three patients with asymmetrical hippocampal sclerosis and three of the nine patients with unilateral hippocampal sclerosis showed significant reductions of FMZ-Vd in the hippocampus contralateral to the side of the EEG focus. Absolute quantification of [11C]FMZ-PET, corrected for partial volume effect, within multiple hippocampal volumes of interest was necessary in order to detect bilateral changes of cBZR in mesial temporal lobe epilepsy due to hippocampal sclerosis with optimal sensitivity. This [11C]FMZ- PET approach was able to demonstrate subtle contralateral abnormalities in one-third of patients thought to have unilateral or bilateral asymmetrical hippocampal sclerosis on MRI. Reduction of cBZR binding was consistently over and above loss of hippocampal volume indicating that atrophy is not the sole determinant of cBZR loss in mesial temporal lobe epilepsy.
Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 BrainHome page
U. Noppeney, C. J. Price, J. S. Duncan, and M. J. Koepp
Reading skills after left anterior temporal lobe resection: an fMRI study
Brain, June 1, 2005; 128(6): 1377 - 1385.
[Abstract] [Full Text] [PDF]

Home page
 JNMHome page
M. Quarantelli, K. Berkouk, A. Prinster, B. Landeau, C. Svarer, L. Balkay, B. Alfano, A. Brunetti, J.-C. Baron, and M. Salvatore
Integrated Software for the Analysis of Brain PET/SPECT Studies with Partial-Volume-Effect Correction
J. Nucl. Med., February 1, 2004; 45(2): 192 - 201.
[Abstract] [Full Text] [PDF]

Home page
 BrainHome page
A. Hammers, M. J. Koepp, M. P. Richardson, R. Hurlemann, D. J. Brooks, and J. S. Duncan
Grey and white matter flumazenil binding in neocortical epilepsy with normal MRI. A PET study of 44 patients
Brain, June 1, 2003; 126(6): 1300 - 1318.
[Abstract] [Full Text] [PDF]

Home page
 BrainHome page
A. Hammers, M. J. Koepp, R. Hurlemann, M. Thom, M. P. Richardson, D. J. Brooks, and J. S. Duncan
Abnormalities of grey and white matter [11C]flumazenil binding in temporal lobe epilepsy with normal MRI
Brain, October 1, 2002; 125(10): 2257 - 2271.
[Abstract] [Full Text] [PDF]

Home page
 BrainHome page
A. Hammers, M. J. Koepp, M. P. Richardson, C. Labbe, D. J. Brooks, V. J. Cunningham, and J. S. Duncan
Central benzodiazepine receptors in malformations of cortical development: A quantitative study
Brain, August 1, 2001; 124(8): 1555 - 1565.
[Abstract] [Full Text] [PDF]

Home page
 NeurologyHome page
A. Hammers, M.J. Koepp, C. Labbe, D.J. Brooks, M. Thom, V.J. Cunningham, and J.S. Duncan
Neocortical abnormalities of [11C]-flumazenil PET in mesial temporal lobe epilepsy
Neurology, April 10, 2001; 56(7): 897 - 906.
[Abstract] [Full Text] [PDF]

Home page
 NeurologyHome page
S. Lamusuo, A. Pitkanen, L. Jutila, A. Ylinen, K. Partanen, R. Kalviainen, H.-M. Ruottinen, V. Oikonen, K. Nagren, P. Lehikoinen, et al.
[11C]Flumazenil binding in the medial temporal lobe in patients with temporal lobe epilepsy: Correlation with hippocampal MR volumetry, T2 relaxometry, and neuropathology
Neurology, June 27, 2000; 54(12): 2252 - 2260.
[Abstract] [Full Text] [PDF]

Home page
 NeurologyHome page
M. J. Koepp, A. Hammers, C. Labbe, F. G. Woermann, D. J. Brooks, and J. S. Duncan
11C-flumazenil PET in patients with refractory temporal lobe epilepsy and normal MRI
Neurology, January 25, 2000; 54(2): 332 - 332.
[Abstract] [Full Text] [PDF]

Home page
 NeurologyHome page
P. Ryvlin, S. Bouvard, D. Le Bars, and F. Mauguiere
Transient and falsely lateralizing flumazenil-PET asymmetries in temporal lobe epilepsy
Neurology, November 1, 1999; 53(8): 1882 - 1882.
[Abstract] [Full Text]


Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.