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PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
1
pubmed:dateCreated
2009-11-5
pubmed:abstractText
The spatial relationship between an intracranial EEG-defined epileptic focus and cortical hypometabolism on glucose PET has not been precisely described. In order to quantitatively evaluate the hypothesis that ictal seizure onset and/or rapid seizure propagation, detected by subdural EEG monitoring, commonly involves normometabolic cortex adjacent to hypometabolic cortical regions, we applied a novel, landmark-constrained conformal mapping approach in 14 children with refractory neocortical epilepsy. The 3D brain surface was parcellated into finite cortical elements (FCEs), and hypometabolism was defined using lobe- and side-specific asymmetry indices derived from normal adult controls. The severity and location of hypometabolic areas vs. ictal intracranial EEG abnormalities were compared on the 3D brain surface. Hypometabolism was more severe in the seizure onset zone than in cortical areas covered by non-onset electrodes. However, similar proportions of the onset electrodes were located over and adjacent to (within 2 cm) hypometabolic regions (46% vs. 41%, respectively), whereas rapid seizure spread electrodes preferred these "adjacent areas" rather than the hypometabolic area itself (51% vs. 22%). On average, 58% of the hypometabolic regions had no early seizure involvement. These findings strongly support that the seizure onset zone often extends from hypometabolic to adjacent normometabolic cortex, while large portions of hypometabolic cortex are not involved in seizure onset or early propagation. The clinical utility of FDG PET in guiding subdural electrode placement in neocortical epilepsy could be greatly enhanced by extending grid coverage to at least 2 cm beyond hypometabolic cortex, when feasible.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Nov
pubmed:issn
1872-6844
pubmed:author
pubmed:copyrightInfo
2009 Elsevier B.V. All rights reserved.
pubmed:issnType
Electronic
pubmed:volume
87
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
77-87
pubmed:meshHeading
pubmed-meshheading:19734012-Adolescent, pubmed-meshheading:19734012-Analysis of Variance, pubmed-meshheading:19734012-Brain Mapping, pubmed-meshheading:19734012-Cerebral Cortex, pubmed-meshheading:19734012-Child, pubmed-meshheading:19734012-Child, Preschool, pubmed-meshheading:19734012-Electroencephalography, pubmed-meshheading:19734012-Energy Metabolism, pubmed-meshheading:19734012-Epilepsy, pubmed-meshheading:19734012-Female, pubmed-meshheading:19734012-Glucose, pubmed-meshheading:19734012-Humans, pubmed-meshheading:19734012-Image Processing, Computer-Assisted, pubmed-meshheading:19734012-Magnetic Resonance Imaging, pubmed-meshheading:19734012-Male, pubmed-meshheading:19734012-Patient Selection, pubmed-meshheading:19734012-Retrospective Studies, pubmed-meshheading:19734012-Severity of Illness Index
pubmed:year
2009
pubmed:articleTitle
Quantitative brain surface mapping of an electrophysiologic/metabolic mismatch in human neocortical epilepsy.
pubmed:affiliation
Carman and Ann Adams Department of Pediatrics, Wayne State University School of Medicine, Detroit, MI, USA.
pubmed:publicationType
Journal Article