Basal ganglia involvement in temporal lobe epilepsy: a functional and morphologic study

Neurology
Viviane BouilleretM-J Ribeiro

Abstract

A decrease of [(18)F]fluoro-l-dopa uptake in basal ganglia was recently reported in medically refractory epilepsy. The purpose of this study was to assess the involvement of dopaminergic neurotransmission in refractory temporal lobe epilepsy (TLE) and its relationship to glucose metabolism and morphologic changes. Twelve TLE patients were studied using [(18)F]fluorodeoxyglucose PET, [(18)F]fluoro-l-dopa PET, and MRI and compared with healthy control volunteers. Morphologic cerebral changes were assessed using voxel-based morphometry. Student t test statistical maps of functional and morphologic differences between patients and controls were obtained using a general linear model. In TLE patients, [(18)F]fluoro-l-dopa uptake was reduced to the same extent in caudate and putamen in both cerebral hemispheres as well as in the substantia nigra (SN). These dopaminergic functional alterations occurred without any glucose metabolism changes in these areas. The only mild morphologic abnormality was found in striatal regions without any changes in the SN. The present study provides support for dopaminergic neurotransmission involvement in temporal lobe epilepsy. The discrepancies between gray matter volume atrophy and the pattern of [(18...Continue Reading

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