Metabolic connectivity as a predictor of surgical outcome in mesial temporal lobe epilepsy
Abstract Objective The study investigated metabolic connectivity (MC) differences between patients with unilateral drug‐resistant mesial temporal lobe epilepsy (MTLE) with hippocampal sclerosis (HS) and healthy controls (HCs), based on [18 F]‐fluorodeoxyglucose (FDG)–PET data. We focused on the MC c...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2024-02-01
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| Series: | Epilepsia Open |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/epi4.12853 |
| _version_ | 1797324278608166912 |
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| author | Ondřej Strýček Pavel Říha Martin Kojan Zdeněk Řehák Milan Brázdil |
| author_facet | Ondřej Strýček Pavel Říha Martin Kojan Zdeněk Řehák Milan Brázdil |
| author_sort | Ondřej Strýček |
| collection | DOAJ |
| description | Abstract Objective The study investigated metabolic connectivity (MC) differences between patients with unilateral drug‐resistant mesial temporal lobe epilepsy (MTLE) with hippocampal sclerosis (HS) and healthy controls (HCs), based on [18 F]‐fluorodeoxyglucose (FDG)–PET data. We focused on the MC changes dependent on the lateralization of the epileptogenic lobe and on correlations with postoperative outcomes. Methods FDG–PET scans of 47 patients with unilateral MTLE with histopathologically proven HS and 25 HC were included in the study. All the patients underwent a standard anterior temporal lobectomy and were more than 2 years after the surgery. MC changes were compared between the two HS groups (left HS, right HS) and HC. Differences between the metabolic network of seizure‐free and non‐seizure‐free patients after surgery were depicted afterward. Network changes were correlated with clinical characteristics. Results The study showed widespread metabolic network changes in the HS patients as compared to HC. The changes were more extensive in the right HS than in the left HS. Unfavorable surgical outcomes were found in patients with decreased MC within the network including both the lesional and contralesional hippocampus, ipsilesional frontal operculum, and contralesional insula. Favorable outcomes correlated with decreased MC within the network involving both orbitofrontal cortices and the ipsilesional temporal lobe. Significance There are major differences in the metabolic networks of left and right HS, with more extensive changes in right HS. The changes within the metabolic network could help predict surgical outcomes in patients with HS. MC may identify patients with potentially unfavorable outcomes and direct them to a more detailed presurgical evaluation. Plain Language Summary Metabolic connectivity is a promising method for metabolic network mapping. Metabolic networks in mesial temporal lobe epilepsy are dependent on lateralization of the epileptogenic lobe and could predict surgical outcomes. |
| first_indexed | 2024-03-08T05:53:48Z |
| format | Article |
| id | doaj.art-91dd9debfc234297ab5efaf0e4c4650e |
| institution | Directory Open Access Journal |
| issn | 2470-9239 |
| language | English |
| last_indexed | 2024-03-08T05:53:48Z |
| publishDate | 2024-02-01 |
| publisher | Wiley |
| record_format | Article |
| series | Epilepsia Open |
| spelling | doaj.art-91dd9debfc234297ab5efaf0e4c4650e2024-02-05T06:37:58ZengWileyEpilepsia Open2470-92392024-02-019118719910.1002/epi4.12853Metabolic connectivity as a predictor of surgical outcome in mesial temporal lobe epilepsyOndřej Strýček0Pavel Říha1Martin Kojan2Zdeněk Řehák3Milan Brázdil4Brno Epilepsy Center, First Department of Neurology, St. Anne's University Hospital and Faculty of Medicine Masaryk University, Member of ERN‐EpiCARE Brno Czech RepublicBrno Epilepsy Center, First Department of Neurology, St. Anne's University Hospital and Faculty of Medicine Masaryk University, Member of ERN‐EpiCARE Brno Czech RepublicBrno Epilepsy Center, First Department of Neurology, St. Anne's University Hospital and Faculty of Medicine Masaryk University, Member of ERN‐EpiCARE Brno Czech RepublicDepartment of Nuclear Medicine Masaryk Memorial Cancer Institute Brno Czech RepublicBrno Epilepsy Center, First Department of Neurology, St. Anne's University Hospital and Faculty of Medicine Masaryk University, Member of ERN‐EpiCARE Brno Czech RepublicAbstract Objective The study investigated metabolic connectivity (MC) differences between patients with unilateral drug‐resistant mesial temporal lobe epilepsy (MTLE) with hippocampal sclerosis (HS) and healthy controls (HCs), based on [18 F]‐fluorodeoxyglucose (FDG)–PET data. We focused on the MC changes dependent on the lateralization of the epileptogenic lobe and on correlations with postoperative outcomes. Methods FDG–PET scans of 47 patients with unilateral MTLE with histopathologically proven HS and 25 HC were included in the study. All the patients underwent a standard anterior temporal lobectomy and were more than 2 years after the surgery. MC changes were compared between the two HS groups (left HS, right HS) and HC. Differences between the metabolic network of seizure‐free and non‐seizure‐free patients after surgery were depicted afterward. Network changes were correlated with clinical characteristics. Results The study showed widespread metabolic network changes in the HS patients as compared to HC. The changes were more extensive in the right HS than in the left HS. Unfavorable surgical outcomes were found in patients with decreased MC within the network including both the lesional and contralesional hippocampus, ipsilesional frontal operculum, and contralesional insula. Favorable outcomes correlated with decreased MC within the network involving both orbitofrontal cortices and the ipsilesional temporal lobe. Significance There are major differences in the metabolic networks of left and right HS, with more extensive changes in right HS. The changes within the metabolic network could help predict surgical outcomes in patients with HS. MC may identify patients with potentially unfavorable outcomes and direct them to a more detailed presurgical evaluation. Plain Language Summary Metabolic connectivity is a promising method for metabolic network mapping. Metabolic networks in mesial temporal lobe epilepsy are dependent on lateralization of the epileptogenic lobe and could predict surgical outcomes.https://doi.org/10.1002/epi4.12853mesial temporal lobe epilepsymetabolic connectivitypositron emission tomography |
| spellingShingle | Ondřej Strýček Pavel Říha Martin Kojan Zdeněk Řehák Milan Brázdil Metabolic connectivity as a predictor of surgical outcome in mesial temporal lobe epilepsy Epilepsia Open mesial temporal lobe epilepsy metabolic connectivity positron emission tomography |
| title | Metabolic connectivity as a predictor of surgical outcome in mesial temporal lobe epilepsy |
| title_full | Metabolic connectivity as a predictor of surgical outcome in mesial temporal lobe epilepsy |
| title_fullStr | Metabolic connectivity as a predictor of surgical outcome in mesial temporal lobe epilepsy |
| title_full_unstemmed | Metabolic connectivity as a predictor of surgical outcome in mesial temporal lobe epilepsy |
| title_short | Metabolic connectivity as a predictor of surgical outcome in mesial temporal lobe epilepsy |
| title_sort | metabolic connectivity as a predictor of surgical outcome in mesial temporal lobe epilepsy |
| topic | mesial temporal lobe epilepsy metabolic connectivity positron emission tomography |
| url | https://doi.org/10.1002/epi4.12853 |
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