Metabolic connectivity is associated with seizure outcome in surgically treated temporal lobe epilepsies: A 18F-FDG PET seed correlation analysis

Doyen, Matthieu; Chawki, Mohammad B.; Heyer, Sébastien; Guedj, Éric; Roch, Véronique; Marie, Pierre-Yves; Tyvaert, Louise; Maillard, Louis; Verger, Antoine

doi:10.1016/j.nicl.2022.103210

Cited by 7 publications

(2 citation statements)

References 41 publications

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“…Furthermore, metabolic connectivity assessed by seed correlation analysis is associated with prognostic outcome in surgically treated TLE. A strengthened epileptogenic connectome is seen in patients with surgical outcomes other than Engel Class 1A (completely seizure-free since surgery) [ 72 ].…”

Section: Combining Different Imaging Modalities For Localising the Ep...mentioning

confidence: 99%

Neurological update: structural and functional imaging in epilepsy surgery

et al. 2023

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Structural and functional imaging prior to surgery in drug-resistant focal epilepsy, has an important role to play alongside electroencephalography (EEG) techniques, in planning the surgical approach and predicting post-operative outcome. This paper reviews the role of structural and functional imaging of the brain, namely computed tomography (CT), magnetic resonance imaging (MRI), functional MRI (fMRI), single photon emission computed tomography (SPECT) and positron emission tomography (PET) imaging in the preoperative work-up of people with medically refractory epilepsy. In MRI-negative patients, the precise localisation of the epileptogenic zone may be established by demonstrating hypometabolism on PET imaging or hyperperfusion on SPECT imaging in the area surrounding the seizure focus. These imaging modalities are far less invasive than intracranial EEG, which is the gold standard but requires surgical placement of electrodes or recording grids. Even when intracranial EEG is needed, PET or SPECT imaging can assist in the planning of EEG electrode placement, due to its’ limited spatial sampling. Multimodal imaging techniques now allow the multidisciplinary epilepsy surgery team to identify and better characterise focal pathology, determine its’ relationship to eloquent areas of the brain and the degree of interconnectedness within both physiological and pathological networks, as well as improve planning and surgical outcomes for patients. This paper will update the reader on this whole field and provide them with a practical guide, to aid them in the selection of appropriate investigations, interpretation of the findings and facilitating patient discussions in individuals with drug-resistant focal epilepsy.

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Section: Combining Different Imaging Modalities For Localising the Ep...mentioning

confidence: 99%

Neurological update: structural and functional imaging in epilepsy surgery

et al. 2023

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“…These FDG-PETs can also provide lower levels of variance, a higher signal-to-noise ratio, and better replicability as compared to fMRI [ 20 ]. Several articles have employed MEG, fMRI, EEG, and DTI to assess functional and structural connectivity in focal epilepsy patients, whereas FDG-PET-based investigations focused on metabolic connectivity in TLE patients have been less common [ 21 , 22 ]. Graph theory has recently been leveraged to conduct a growing number of network analyses in MTLE patients with FBTCS through resting-state fMRI, task-based fMRI, and DTI approaches, with all of these strategies revealing altered network status [ 9 , 23 , 24 ].…”

Section: Introductionmentioning

confidence: 99%

Altered Metabolic Networks in Mesial Temporal Lobe Epilepsy with Focal to Bilateral Seizures

Guo,

Mo,

Zhang

et al. 2023

Brain Sciences

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This study was designed to identify whether the metabolic network changes in mesial temporal lobe epilepsy (MTLE) patients with focal to bilateral tonic-clonic seizures (FBTCS) differ from changes in patients without FBTCS. This retrospective analysis enrolled 30 healthy controls and 54 total MTLE patients, of whom 27 had FBTCS. Fluorodeoxyglucose positron emission tomography (FDG-PET) data and graph theoretical analyses were used to examine metabolic connectivity. The differences in metabolic networks between the three groups were compared. Significant changes in both local and global network topology were evident in FBTCS+ patients as compared to healthy controls, with a lower assortative coefficient and altered betweenness centrality in 15 brain regions. While global network measures did not differ significantly when comparing FBTCS− patients to healthy controls, alterations in betweenness centrality were evident in 13 brain regions. Significantly altered betweenness centrality was also observed in four brain regions when comparing patients with and without FBTCS. The study revealed greater metabolic network abnormalities in MTLE patients with FBTCS as compared to FBTCS− patients, indicating the existence of distinct epileptogenic networks. These findings can provide insight into the pathophysiological basis of FBTCS.

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EANM practice guidelines for an appropriate use of PET and SPECT for patients with epilepsy

Traub-Weidinger,

Arbizu,

Barthel

et al. 2024

Eur J Nucl Med Mol Imaging

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Epilepsy is one of the most frequent neurological conditions with an estimated prevalence of more than 50 million people worldwide and an annual incidence of two million. Although pharmacotherapy with anti-seizure medication (ASM) is the treatment of choice, ~30% of patients with epilepsy do not respond to ASM and become drug resistant. Focal epilepsy is the most frequent form of epilepsy. In patients with drug-resistant focal epilepsy, epilepsy surgery is a treatment option depending on the localisation of the seizure focus for seizure relief or seizure freedom with consecutive improvement in quality of life. Beside examinations such as scalp video/electroencephalography (EEG) telemetry, structural, and functional magnetic resonance imaging (MRI), which are primary standard tools for the diagnostic work-up and therapy management of epilepsy patients, molecular neuroimaging using different radiopharmaceuticals with single-photon emission computed tomography (SPECT) and positron emission tomography (PET) influences and impacts on therapy decisions. To date, there are no literature-based praxis recommendations for the use of Nuclear Medicine (NM) imaging procedures in epilepsy. The aims of these guidelines are to assist in understanding the role and challenges of radiotracer imaging for epilepsy; to provide practical information for performing different molecular imaging procedures for epilepsy; and to provide an algorithm for selecting the most appropriate imaging procedures in specific clinical situations based on current literature. These guidelines are written and authorized by the European Association of Nuclear Medicine (EANM) to promote optimal epilepsy imaging, especially in the presurgical setting in children, adolescents, and adults with focal epilepsy. They will assist NM healthcare professionals and also specialists such as Neurologists, Neurophysiologists, Neurosurgeons, Psychiatrists, Psychologists, and others involved in epilepsy management in the detection and interpretation of epileptic seizure onset zone (SOZ) for further treatment decision. The information provided should be applied according to local laws and regulations as well as the availability of various radiopharmaceuticals and imaging modalities.

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Metabolic connectivity is associated with seizure outcome in surgically treated temporal lobe epilepsies: A 18F-FDG PET seed correlation analysis

Cited by 7 publications

References 41 publications

Neurological update: structural and functional imaging in epilepsy surgery

Neurological update: structural and functional imaging in epilepsy surgery

Altered Metabolic Networks in Mesial Temporal Lobe Epilepsy with Focal to Bilateral Seizures

EANM practice guidelines for an appropriate use of PET and SPECT for patients with epilepsy

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