Central‐type Benzodiazepine Receptors and Epileptogenesis: Basic Mechanisms and Clinical Validity

Morimoto, Kiyoshi; Tamagami, Hiroshi; Matsuda, Kazumi

doi:10.1111/j.1528-1167.2005.01030.x

Cited by 19 publications

(8 citation statements)

References 20 publications

(30 reference statements)

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“…Studies in mesial TLE showed decreased binding that correlated with decreased neuronal density in the hippocampus and dentate gyrus. Similar changes were present in neocortical dysplasia, even in the absence of structural MRI lesions or SPECT studies evaluating cerebral blood flow [108,109]. Among patients who had severe TBI, hypoperfusion in the temporal lobes 1 year after trauma, as measured with 99m Tc hexamethyl-propyleneamine-oxime, correlated highly with the development of PTE [110].…”

Section: Single Photon Emission Computed Tomographysupporting

confidence: 49%

Neuroimaging the Epileptogenic Process

et al. 2014

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Epilepsy is one of the most common chronic neurological conditions worldwide. Anti-epileptic drugs (AEDs) can suppress seizures, but do not affect the underlying epileptic state, and many epilepsy patients are unable to attain seizure control with AEDs. To cure or prevent epilepsy, disease-modifying interventions that inhibit or reverse the disease process of epileptogenesis must be developed. A major limitation in the development and implementation of such an intervention is the current poor understanding, and the lack of reliable biomarkers, of the epileptogenic process. Neuroimaging represents a non-invasive medical and research tool with the ability to identify early pathophysiological changes involved in epileptogenesis, monitor disease progression, and assess the effectiveness of possible therapies. Here we will provide an overview of studies conducted in animal models and in patients with epilepsy that have utilized various neuroimaging modalities to investigate epileptogenesis.

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Section: Single Photon Emission Computed Tomographysupporting

confidence: 49%

Neuroimaging the Epileptogenic Process

et al. 2014

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“…It has been reported that a low IMZ uptake level correlates with decreased neuronal density in epilepsy patients [7, 9]; and IMZ has already been used for epilepsy diagnosis in clinical practice.…”

Section: Discussionmentioning

confidence: 99%

I-123 iomazenil single photon emission computed tomography for detecting loss of neuronal integrity in patients with traumatic brain injury

et al. 2017

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BackgroundTraumatic brain injury (TBI) causes brain dysfunction in many patients. Using C-11 flumazenil (FMZ) positron emission tomography (PET), we have detected and reported the loss of neuronal integrity, leading to brain dysfunction in TBI patients. Similarly to FMZ PET, I-123 iomazenil (IMZ) single photon emission computed tomography (SPECT) is widely used to determine the distribution of the benzodiazepine receptor (BZR) in the brain cortex. The purpose of this study is to examine whether IMZ SPECT is as useful as FMZ PET for evaluating the loss of neuronal integrity in TBI patients.The subjects of this study were seven patients who suffered from neurobehavioral disability. They underwent IMZ SPECT and FMZ PET. Nondisplaceable binding potential (BPND) was calculated from FMZ PET images. The uptake of IMZ was evaluated on the basis of lesion-to-pons ratio (LPR). The locations of low uptake levels were visually evaluated both in IMZ SPECT and FMZ PET images. We compared FMZ BPND and (LPR-1) of IMZ SPECT.ResultsIn the visual assessment, FMZ BPND decreased in 11 regions. In IMZ SPECT, low uptake levels were observed in eight of the 11 regions. The rate of concordance between FMZ PET and IMZ SPECT was 72.7%. The mean values IMZ (LPR-1) (1.95 ± 1.01) was significantly lower than that of FMZ BPND (2.95 ± 0.80 mL/mL). There was good correlation between FMZ BPND and IMZ (LPR-1) (r = 0.80).ConclusionsIMZ SPECT findings were almost the same as FMZ PET findings in TBI patients. The results indicated that IMZ SPECT is useful for evaluating the loss of neuronal integrity. Because IMZ SPECT can be performed in various facilities, IMZ SPECT may become widely adopted for evaluating the loss of neuronal integrity.

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“…49 It has not yet been proven that either of the available benzodiazepine ligands is more accurate for delineation of the seizure focus than the functional imaging techniques already in clinical use (as detailed above). 48,[50][51][52] There are promising indications. When hippocampal sclerosis was present, the area of abnormality was often larger on FDG-PET than on FMZ-PET, which more closely matched the epileptogenic zone as determined by intracranial EEG.…”

Section: Benzodiazepine-gaba a Receptormentioning

confidence: 97%

Sudden Onset Panic: Epileptic Aura or Panic Disorder?

Hurley¹,

Fisher²,

Taber³

2006

JNP

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Cover and Figure 1. The location and extent of the temporal lobe (pink), the hippocampus (green) and the amygdala (blue) are color-coded onto a lateral drawing of the brain and representative coronal and axial magnetic resonance (MR) images. Landmarks commonly used for identification of the boundary between the amygdala and anterior hippocampus are labeled in yellow. 1,2 The dashed lines on the lateral view of the brain indicate the locations and orientations for the two MR sections. Figure 2.Nuclear medicine scans obtained during a seizure (ictal scan) will show increased perfusion or metabolism in the epileptic focus (arrows), as illustrated here with both coronal and axial single photon emission computed tomography (SPECT) images of cerebral blood flow. Scans obtained in the absence of seizure (interictal scan) will show decreased perfusion or metabolism (arrows). Figure 3.Nuclear medicine scans acquired under resting conditions from patients with panic disorder have areas of increased (yellow, orange) and decreased (blue, green, purple) perfusion or metabolism compared with healthy individuals. 3-6 Reported differences were in the range of 5% to 10%, smaller than is typically seen in epilepsy.

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Central‐type Benzodiazepine Receptors and Epileptogenesis: Basic Mechanisms and Clinical Validity

Cited by 19 publications

References 20 publications

Neuroimaging the Epileptogenic Process

Neuroimaging the Epileptogenic Process

I-123 iomazenil single photon emission computed tomography for detecting loss of neuronal integrity in patients with traumatic brain injury

Sudden Onset Panic: Epileptic Aura or Panic Disorder?

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