Metabolic profiles and correlation with surgical outcomes in mesial versus neocortical temporal lobe epilepsy
Aims Differentiating mesial temporal lobe epilepsy (MTLE) and neocortical temporal lobe epilepsy (NTLE) remains challenging. Our study characterized the metabolic profiles between MTLE and NTLE and their correlation with surgical prognosis using 18F‐FDG‐PET. Methods A total of 137 patients with intr...
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| Veröffentlicht in: | CNS neuroscience & therapeutics 2023-09, Vol.29 (9), p.2656-2665 |
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| creator | Zhu, Hao‐yue Tang, Yong‐xiang Xiao, Ling Wen, Shi‐rui Wu, Yuan‐xia Yang, Zhi‐quan Zhou, Luo Xiao, Bo Feng, Li Hu, Shuo |
| description | Aims
Differentiating mesial temporal lobe epilepsy (MTLE) and neocortical temporal lobe epilepsy (NTLE) remains challenging. Our study characterized the metabolic profiles between MTLE and NTLE and their correlation with surgical prognosis using 18F‐FDG‐PET.
Methods
A total of 137 patients with intractable temporal lobe epilepsy (TLE) and 40 age‐matched healthy controls were recruited. Patients were divided into the MTLE group (N = 91) and the NTLE group (N = 46). 18F‐FDG‐PET was used to measure the metabolism of regional cerebra, which was analyzed using statistical parametric mapping. The volume of abnormal metabolism in cerebral regions and their relationship with surgical prognosis were calculated for each surgical patient.
Results
The cerebral hypometabolism of MTLE was limited to the ipsilateral temporal and insular lobes (p |
| doi_str_mv | 10.1111/cns.14209 |
| format | Article |
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Differentiating mesial temporal lobe epilepsy (MTLE) and neocortical temporal lobe epilepsy (NTLE) remains challenging. Our study characterized the metabolic profiles between MTLE and NTLE and their correlation with surgical prognosis using 18F‐FDG‐PET.
Methods
A total of 137 patients with intractable temporal lobe epilepsy (TLE) and 40 age‐matched healthy controls were recruited. Patients were divided into the MTLE group (N = 91) and the NTLE group (N = 46). 18F‐FDG‐PET was used to measure the metabolism of regional cerebra, which was analyzed using statistical parametric mapping. The volume of abnormal metabolism in cerebral regions and their relationship with surgical prognosis were calculated for each surgical patient.
Results
The cerebral hypometabolism of MTLE was limited to the ipsilateral temporal and insular lobes (p < 0.001, uncorrected). The NTLE patients showed hypometabolism in the ipsilateral temporal, frontal, and parietal lobes (p < 0.001, uncorrected). The MTLE patients showed extensive hypermetabolism in cerebral regions (p < 0.001, uncorrected). Hypermetabolism in NTLE was limited to the contralateral temporal lobe and cerebellum, ipsilateral frontal lobe, occipital lobe, and bilateral thalamus (p < 0.001, uncorrected). Among patients who underwent resection of epileptic lesions, 51 (67.1%) patients in the MTLE group and 10 (43.5%) in the NTLE group achieved Engel class IA outcome (p = 0.041). The volumes of metabolic increase for the frontal lobe or thalamus in the MTLE group were larger in non‐Engel class IA patients than Engel class IA patients (p < 0.05).
Conclusions
The spatial metabolic profile discriminated NTLE from MTLE. Hypermetabolism of the thalamus and frontal lobe in MTLE may facilitate preoperative counseling and surgical planning.
A striking difference in metabolic patterns using whole‐brain voxel‐based 18F‐FDG‐PET between mesial temporal lobe epilepsy (MTLE) and neocortical temporal lobe epilepsy (NTLE) was observed. The difference in metabolic patterns between the two temporal lobe epilepsy (TLE) subtypes may represent distinct epileptic networks that may guide the clinical classification of TLE. The presence of hypermetabolism involving the thalamus and frontal lobe in MTLE may be a predictor of an unfavorable seizure outcome in MTLE.</description><identifier>ISSN: 1755-5930</identifier><identifier>EISSN: 1755-5949</identifier><identifier>DOI: 10.1111/cns.14209</identifier><identifier>PMID: 37017415</identifier><language>eng</language><publisher>England: John Wiley & Sons, Inc</publisher><subject>18F‐FDG‐PET ; Age ; Alzheimer's disease ; Cerebellum ; Convulsions & seizures ; Dementia ; Drug resistance ; Electroencephalography ; Epilepsy ; Frontal lobe ; Glucose ; Localization ; Magnetic resonance imaging ; metabolic profile ; Metabolism ; MTLE ; NTLE ; Occipital lobe ; Original ; Patients ; Positron emission tomography ; Prognosis ; Surgical outcomes ; surgical prognosis ; Temporal lobe ; Thalamus ; Tomography</subject><ispartof>CNS neuroscience & therapeutics, 2023-09, Vol.29 (9), p.2656-2665</ispartof><rights>2023 The Authors. published by John Wiley & Sons Ltd.</rights><rights>2023 The Authors. CNS Neuroscience & Therapeutics published by John Wiley & Sons Ltd.</rights><rights>2023. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4449-1bca3b14a48be43f1f95ec41d2a765be573eb417552c2d7f88b7419b660f52ff3</citedby><cites>FETCH-LOGICAL-c4449-1bca3b14a48be43f1f95ec41d2a765be573eb417552c2d7f88b7419b660f52ff3</cites><orcidid>0000-0002-4707-9161 ; 0000-0003-0998-8943 ; 0000-0001-9808-4000 ; 0000-0001-7658-1399 ; 0000-0001-5204-1902</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10401181/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10401181/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,1411,11541,27901,27902,45550,45551,46027,46451,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37017415$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Zhu, Hao‐yue</creatorcontrib><creatorcontrib>Tang, Yong‐xiang</creatorcontrib><creatorcontrib>Xiao, Ling</creatorcontrib><creatorcontrib>Wen, Shi‐rui</creatorcontrib><creatorcontrib>Wu, Yuan‐xia</creatorcontrib><creatorcontrib>Yang, Zhi‐quan</creatorcontrib><creatorcontrib>Zhou, Luo</creatorcontrib><creatorcontrib>Xiao, Bo</creatorcontrib><creatorcontrib>Feng, Li</creatorcontrib><creatorcontrib>Hu, Shuo</creatorcontrib><title>Metabolic profiles and correlation with surgical outcomes in mesial versus neocortical temporal lobe epilepsy</title><title>CNS neuroscience & therapeutics</title><addtitle>CNS Neurosci Ther</addtitle><description>Aims
Differentiating mesial temporal lobe epilepsy (MTLE) and neocortical temporal lobe epilepsy (NTLE) remains challenging. Our study characterized the metabolic profiles between MTLE and NTLE and their correlation with surgical prognosis using 18F‐FDG‐PET.
Methods
A total of 137 patients with intractable temporal lobe epilepsy (TLE) and 40 age‐matched healthy controls were recruited. Patients were divided into the MTLE group (N = 91) and the NTLE group (N = 46). 18F‐FDG‐PET was used to measure the metabolism of regional cerebra, which was analyzed using statistical parametric mapping. The volume of abnormal metabolism in cerebral regions and their relationship with surgical prognosis were calculated for each surgical patient.
Results
The cerebral hypometabolism of MTLE was limited to the ipsilateral temporal and insular lobes (p < 0.001, uncorrected). The NTLE patients showed hypometabolism in the ipsilateral temporal, frontal, and parietal lobes (p < 0.001, uncorrected). The MTLE patients showed extensive hypermetabolism in cerebral regions (p < 0.001, uncorrected). Hypermetabolism in NTLE was limited to the contralateral temporal lobe and cerebellum, ipsilateral frontal lobe, occipital lobe, and bilateral thalamus (p < 0.001, uncorrected). Among patients who underwent resection of epileptic lesions, 51 (67.1%) patients in the MTLE group and 10 (43.5%) in the NTLE group achieved Engel class IA outcome (p = 0.041). The volumes of metabolic increase for the frontal lobe or thalamus in the MTLE group were larger in non‐Engel class IA patients than Engel class IA patients (p < 0.05).
Conclusions
The spatial metabolic profile discriminated NTLE from MTLE. Hypermetabolism of the thalamus and frontal lobe in MTLE may facilitate preoperative counseling and surgical planning.
A striking difference in metabolic patterns using whole‐brain voxel‐based 18F‐FDG‐PET between mesial temporal lobe epilepsy (MTLE) and neocortical temporal lobe epilepsy (NTLE) was observed. The difference in metabolic patterns between the two temporal lobe epilepsy (TLE) subtypes may represent distinct epileptic networks that may guide the clinical classification of TLE. The presence of hypermetabolism involving the thalamus and frontal lobe in MTLE may be a predictor of an unfavorable seizure outcome in MTLE.</description><subject>18F‐FDG‐PET</subject><subject>Age</subject><subject>Alzheimer's disease</subject><subject>Cerebellum</subject><subject>Convulsions & seizures</subject><subject>Dementia</subject><subject>Drug resistance</subject><subject>Electroencephalography</subject><subject>Epilepsy</subject><subject>Frontal lobe</subject><subject>Glucose</subject><subject>Localization</subject><subject>Magnetic resonance imaging</subject><subject>metabolic profile</subject><subject>Metabolism</subject><subject>MTLE</subject><subject>NTLE</subject><subject>Occipital lobe</subject><subject>Original</subject><subject>Patients</subject><subject>Positron emission tomography</subject><subject>Prognosis</subject><subject>Surgical outcomes</subject><subject>surgical prognosis</subject><subject>Temporal lobe</subject><subject>Thalamus</subject><subject>Tomography</subject><issn>1755-5930</issn><issn>1755-5949</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>BENPR</sourceid><recordid>eNp1kU9v1DAQxS0Eon_ooV-gssSFHra1HTuJTwitoK1U4ACcLds7bl0lcbCTVvvtO91tV4CELzOyf36aN4-QY87OOJ5zP5QzLgXTr8g-b5RaKC31611fsT1yUModY7VodfuW7FUN443kap_0X2GyLnXR0zGnEDso1A4r6lPO0NkppoE-xOmWljnfRG87mubJpx6xOFAsEa_uIZe50AESfps21AT9mDI2XXJAYUThsazfkTfBdgWOnush-fXl88_l5eL6-8XV8tP1wksp9YI7byvHpZWtA1kFHrQCL_lK2KZWDlRTgZNP7oQXqya0rUM32tU1C0qEUB2Sj1vdcXY9rDwME85ixhx7m9cm2Wj-fhnirblJ94YzyThvOSp8eFbI6fcMZTJ9LB66zqLLuRjR6JrXot6g7_9B79KcB_RnRCtVpWtcO1KnW8rnVEqGsJuGM_OUosEUzSZFZE_-HH9HvsSGwPkWeMC9rv-vZJbffmwlHwG0oqly</recordid><startdate>202309</startdate><enddate>202309</enddate><creator>Zhu, Hao‐yue</creator><creator>Tang, Yong‐xiang</creator><creator>Xiao, Ling</creator><creator>Wen, Shi‐rui</creator><creator>Wu, Yuan‐xia</creator><creator>Yang, Zhi‐quan</creator><creator>Zhou, Luo</creator><creator>Xiao, Bo</creator><creator>Feng, Li</creator><creator>Hu, Shuo</creator><general>John Wiley & Sons, Inc</general><general>John Wiley and Sons Inc</general><scope>24P</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>8AO</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>LK8</scope><scope>M0S</scope><scope>M7P</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-4707-9161</orcidid><orcidid>https://orcid.org/0000-0003-0998-8943</orcidid><orcidid>https://orcid.org/0000-0001-9808-4000</orcidid><orcidid>https://orcid.org/0000-0001-7658-1399</orcidid><orcidid>https://orcid.org/0000-0001-5204-1902</orcidid></search><sort><creationdate>202309</creationdate><title>Metabolic profiles and correlation with surgical outcomes in mesial versus neocortical temporal lobe epilepsy</title><author>Zhu, Hao‐yue ; Tang, Yong‐xiang ; Xiao, Ling ; Wen, Shi‐rui ; Wu, Yuan‐xia ; Yang, Zhi‐quan ; Zhou, Luo ; Xiao, Bo ; Feng, Li ; Hu, Shuo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4449-1bca3b14a48be43f1f95ec41d2a765be573eb417552c2d7f88b7419b660f52ff3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>18F‐FDG‐PET</topic><topic>Age</topic><topic>Alzheimer's disease</topic><topic>Cerebellum</topic><topic>Convulsions & seizures</topic><topic>Dementia</topic><topic>Drug resistance</topic><topic>Electroencephalography</topic><topic>Epilepsy</topic><topic>Frontal lobe</topic><topic>Glucose</topic><topic>Localization</topic><topic>Magnetic resonance imaging</topic><topic>metabolic profile</topic><topic>Metabolism</topic><topic>MTLE</topic><topic>NTLE</topic><topic>Occipital lobe</topic><topic>Original</topic><topic>Patients</topic><topic>Positron emission tomography</topic><topic>Prognosis</topic><topic>Surgical outcomes</topic><topic>surgical prognosis</topic><topic>Temporal lobe</topic><topic>Thalamus</topic><topic>Tomography</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zhu, Hao‐yue</creatorcontrib><creatorcontrib>Tang, Yong‐xiang</creatorcontrib><creatorcontrib>Xiao, Ling</creatorcontrib><creatorcontrib>Wen, Shi‐rui</creatorcontrib><creatorcontrib>Wu, Yuan‐xia</creatorcontrib><creatorcontrib>Yang, Zhi‐quan</creatorcontrib><creatorcontrib>Zhou, Luo</creatorcontrib><creatorcontrib>Xiao, Bo</creatorcontrib><creatorcontrib>Feng, Li</creatorcontrib><creatorcontrib>Hu, Shuo</creatorcontrib><collection>Wiley Online Library Open Access</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Neurosciences Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>ProQuest Pharma Collection</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Biological Science Database</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>CNS neuroscience & therapeutics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zhu, Hao‐yue</au><au>Tang, Yong‐xiang</au><au>Xiao, Ling</au><au>Wen, Shi‐rui</au><au>Wu, Yuan‐xia</au><au>Yang, Zhi‐quan</au><au>Zhou, Luo</au><au>Xiao, Bo</au><au>Feng, Li</au><au>Hu, Shuo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Metabolic profiles and correlation with surgical outcomes in mesial versus neocortical temporal lobe epilepsy</atitle><jtitle>CNS neuroscience & therapeutics</jtitle><addtitle>CNS Neurosci Ther</addtitle><date>2023-09</date><risdate>2023</risdate><volume>29</volume><issue>9</issue><spage>2656</spage><epage>2665</epage><pages>2656-2665</pages><issn>1755-5930</issn><eissn>1755-5949</eissn><abstract>Aims
Differentiating mesial temporal lobe epilepsy (MTLE) and neocortical temporal lobe epilepsy (NTLE) remains challenging. Our study characterized the metabolic profiles between MTLE and NTLE and their correlation with surgical prognosis using 18F‐FDG‐PET.
Methods
A total of 137 patients with intractable temporal lobe epilepsy (TLE) and 40 age‐matched healthy controls were recruited. Patients were divided into the MTLE group (N = 91) and the NTLE group (N = 46). 18F‐FDG‐PET was used to measure the metabolism of regional cerebra, which was analyzed using statistical parametric mapping. The volume of abnormal metabolism in cerebral regions and their relationship with surgical prognosis were calculated for each surgical patient.
Results
The cerebral hypometabolism of MTLE was limited to the ipsilateral temporal and insular lobes (p < 0.001, uncorrected). The NTLE patients showed hypometabolism in the ipsilateral temporal, frontal, and parietal lobes (p < 0.001, uncorrected). The MTLE patients showed extensive hypermetabolism in cerebral regions (p < 0.001, uncorrected). Hypermetabolism in NTLE was limited to the contralateral temporal lobe and cerebellum, ipsilateral frontal lobe, occipital lobe, and bilateral thalamus (p < 0.001, uncorrected). Among patients who underwent resection of epileptic lesions, 51 (67.1%) patients in the MTLE group and 10 (43.5%) in the NTLE group achieved Engel class IA outcome (p = 0.041). The volumes of metabolic increase for the frontal lobe or thalamus in the MTLE group were larger in non‐Engel class IA patients than Engel class IA patients (p < 0.05).
Conclusions
The spatial metabolic profile discriminated NTLE from MTLE. Hypermetabolism of the thalamus and frontal lobe in MTLE may facilitate preoperative counseling and surgical planning.
A striking difference in metabolic patterns using whole‐brain voxel‐based 18F‐FDG‐PET between mesial temporal lobe epilepsy (MTLE) and neocortical temporal lobe epilepsy (NTLE) was observed. The difference in metabolic patterns between the two temporal lobe epilepsy (TLE) subtypes may represent distinct epileptic networks that may guide the clinical classification of TLE. The presence of hypermetabolism involving the thalamus and frontal lobe in MTLE may be a predictor of an unfavorable seizure outcome in MTLE.</abstract><cop>England</cop><pub>John Wiley & Sons, Inc</pub><pmid>37017415</pmid><doi>10.1111/cns.14209</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0002-4707-9161</orcidid><orcidid>https://orcid.org/0000-0003-0998-8943</orcidid><orcidid>https://orcid.org/0000-0001-9808-4000</orcidid><orcidid>https://orcid.org/0000-0001-7658-1399</orcidid><orcidid>https://orcid.org/0000-0001-5204-1902</orcidid><oa>free_for_read</oa></addata></record> |
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| source | Wiley Online Library Open Access; DOAJ Directory of Open Access Journals; Wiley Online Library Journals Frontfile Complete; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central |
| subjects | 18F‐FDG‐PET Age Alzheimer's disease Cerebellum Convulsions & seizures Dementia Drug resistance Electroencephalography Epilepsy Frontal lobe Glucose Localization Magnetic resonance imaging metabolic profile Metabolism MTLE NTLE Occipital lobe Original Patients Positron emission tomography Prognosis Surgical outcomes surgical prognosis Temporal lobe Thalamus Tomography |
| title | Metabolic profiles and correlation with surgical outcomes in mesial versus neocortical temporal lobe epilepsy |
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