Abstracts

[¹⁸F]FDG-PET provided in vivo that brain abnormalities associated with temporal lobe epilepsy (TLE) extend beyond the hippocampus involving the basal ganglia (BG). More recently, using [¹⁸F]Fluoro-L-DOPA and PET, a BG decreased dopamine uptake has been reported. However, the relationship between such changes remained to be determined. Voxel-based morphometry (VBM) is a fully automated image analysis technique allowing identification of regional differences in grey matter concentration (GMC) and white matter concentration (WMC) between groups of subjects without a prior region of interest. The purpose of this study is to determine the relationship between functional (metabolic and dopaminergic) and morphological cerebral changes in TLE, mainly in BG., Twelve TLE patients resistant to medicamental treatment were studied in PET using [¹⁸F]FDG and [¹⁸F]Fluoro-L-DOPA, as also in MRI. They were compared to age- and sex-matched healthy control subjects. The seizure focus was left sided. Student[apos]s [italic]t[/italic] test statistical maps of functional and morphological differences between patients and controls were obtained using a general linear model., The pattern of hypometabolim extends beyond the hippocampus to the temporal pole and the frontal lobe. GMC reduction concerns the temporopolar, entorhinal, and perirhinal areas mainly ipsilateral to the seizure focus. This topography concern also the adjacent WMC reduction. GMC reduction extends also to the temporal neocortex and the insula. In the thalamus, a hypometabolism ipsilateral to the seizure side could be noticed, while GMC decrease occurs also in both thalami. In the BG, no hypometabolism could be noticed but a bilateral GMC decrease in the caudate is observed, predominating to the seizure focus side. Finally, the [¹⁸F]Fluoro-L-DOPA uptake decrease occurs in caudate and putamen of both side and in the same extend., Hypometabolism could be a consequence of GMC decrease in the cortical area, while BG involvement appears to be a functional outcome of recurring epileptic seizures.,