Correlation of FDG-PET Hypometabolism and SEEG Epileptogenicity Mapping in Patients With Drug-Resistant Focal Epilepsy

Epilepsia. 2016 Dec;57(12):2045-2055. doi: 10.1111/epi.13592. Epub 2016 Nov 8.

Abstract

Objective: Interictal [18F]fluorodeoxyglucose-positron emission tomography (FDG-PET) is used in the presurgical evaluation of patients with drug-resistant focal epilepsy. We aimed at clarifying its relationships with ictal high-frequency oscillations (iHFOs) shown to be a relevant marker of the seizure-onset zone.

Methods: We studied the correlation between FDG-PET and epileptogenicity maps in an unselected series of 37 successive patients having been explored with stereo-electroencephalography (SEEG).

Results: At the group level, we found a significant correlation between iHFOs and FDG-PET interictal hypometabolism only in cases of temporal lobe epilepsy. This correlation was found with HFOs, and the same comparison between FDG-PET and ictal SEEG power of lower frequencies during the same epochs did not show the same significance.

Significance: This finding suggests that interictal FDG-PET and ictal HFOs may share common underlying pathophysiologic mechanisms of ictogenesis in temporal lobe epilepsy, and combining both features may help to identify the seizure-onset zone.

Keywords: SEEG; Epileptogenicity map; FDG-PET; Focal epilepsy; Ictal HFO.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Brain Mapping*
  • Child
  • Electrodes, Implanted
  • Electroencephalography*
  • Epilepsies, Partial / diagnostic imaging*
  • Epilepsies, Partial / physiopathology*
  • Female
  • Fluorodeoxyglucose F18 / metabolism*
  • Humans
  • Image Processing, Computer-Assisted
  • Male
  • Middle Aged
  • Positron-Emission Tomography*
  • Statistics as Topic
  • Young Adult

Substances

  • Fluorodeoxyglucose F18