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Cited by 224Epilepsy research and treatmentMedical Imaging Techniques and ApplicationsAdvanced MRI Techniques and Applications

PET and SPECT in epilepsy: a critical review.

la Fougère, C., Rominger, A., Förster, S., Geisler, J., Bartenstein, P.·2009·Epilepsy & Behavior
DOI 10.1016/j.yebeh.2009.02.025
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Abstract

Molecular imaging with ictal and interictal single-photon emission computed tomography (SPECT) as well as positron emission tomography (PET) rank among the established functional imaging tests for the presurgical evaluation of epileptic onset zone in patients with intractable partial epilepsy. In temporal lobe epilepsy the sensitivity of these methods was shown to be excellent, in particular if a multimodal platform is used, which combines the functional imaging with the additional morphological information of magnetic resonance imaging (MRI), but was lower in extra temporal lobe epilepsy. Functional imaging with SPECT and PET reflects seizure related changes of cerebral perfusion, glucose-metabolism and neuroreceptor status. In this review the usefulness of SPECT and PET imaging in clinical routine in epilepsy as well as the role of different neuroreceptor PET-tracer, which were used in epilepsy are discussed. The use of perfusion SPECT tracer allows the investigation of ictal activations, but the low temporal resolution of ictal perfusion SPECT often results in the detection of both the ictal onset zone as well as the propagation pathways, an area that has not always need to be resected in order to render a patient seizure free. The additional use of interictal PET with fluorine-18 fluorodeoxyglucose which measures regional cerebral metabolism or interictal perfusion SPECT enhance the informational value of ictal SPECT and were shown to be important tools to better define the ictal onset and surround inhibition zones. In recent years PET imaging of different cerebral neuroreceptor-systems inter alia GABA(A) receptors, serotonin receptors (5-HT(1A)), opioid receptors as well as dopamine receptors was used to investigate the neurochemical basis of epilepsy, the role of these neurotransmitters for the epileptogenesis as well as the spread of epileptic activity during seizures and partially entered in clinical routine. Currently some of these radioligands are also used to investigate new treatment approaches.

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  • Chronic impairments of neuronal metabolism would be expected to compromise brain function and contribute to brain pathology.

    “For the same reason, chronic impairments of neuronal metabolism would be expected to compromise brain function and contribute to brain pathology, which may be the case in epilepsy (due to runaway excitatory activity or directly to metabolic disorders [57]), sepsis [58], mitochondrial disorders, which strongly affect the brain [59], and Alzheimer's disease [60].”

    From Scaling of Brain Metabolism with a Fixed Energy Budget per Neuron: Implications for Neuronal Activity, Plasticity and Evolution (2011) · cites this paper as [57]

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Authors
la Fougère, C., Rominger, A., Förster, S., Geisler, J., & Bartenstein, P.
Affiliations
Ludwig-Maximilians-Universität München (DE)
ORCID
Venue
Epilepsy & Behavior
Publisher
Elsevier BV
Published
2009-05
Volume
15
Issue
1
Pages
50-55
ISSN
1525-5050 (ISSN-L)
DOI
10.1016/j.yebeh.2009.02.025
OpenAlex
W2160408625
Cited by
224
References
60
Citations by year
2026: 3 · 2025: 18 · 2024: 12 · 2023: 9 · 2022: 8 · 2021: 19 · 2020: 17 · 2019: 12 · 2018: 12 · 2017: 11 · 2016: 13 · 2015: 13 · 2014: 17 · 2013: 13 · 2012: 12
FWCI
1.98
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Epilepsy & Behavior (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Epilepsy research and treatment
  • Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Medical Imaging Techniques and Applications
  • Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Advanced MRI Techniques and Applications
Keywords
epilepsy, ictal SPECT, preoperative assessment, intractable partial epilepsy, temporal lobe epilepsy, extratemporal epilepsy, cerebral perfusion, FDG-PET, GABAA receptor, 5-HT1A receptor, opioid receptors, dopamine receptors, epileptogenesis, seizure propagation, multimodal imaging
MeSH terms
Brain Mapping, Epilepsy, Humans, Image Processing, Computer-Assisted, Iodine Radioisotopes, Receptors, Dopamine, Receptors, Opioid, Receptors, GABA-A, Tomography, Emission-Computed, Single-Photon, Receptors, GABA, Receptor, Serotonin, 5-HT1A, Positron-Emission Tomography

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