ABSTRACT
Repetitive limbic status epilepticus was produced in one baboon by intraamygdaloid microinjection of kainic acid. Brain metabolism was analysed by positron emission tomography (PET) after intravenous administration 18fluorodeoxyglucose (18FDG). In a control examination the distribution of 18FDG was symmetric in homologous parts of the brain. In contrast, during the epileptic state a restricted zone, the fronto-temporal region, showed increased 18FDG incorporation. This region corresponded to the side of kainic acid injection and to the limbic epileptogenic focus as demonstrated by EEG recording. The use of the non-invasive PET technique is suggested as an adjunct to classical EEG and clinical observation for the localization of an epileptic focus generating a status epilepticus.
Subject(s)
Brain/diagnostic imaging , Deoxy Sugars , Deoxyglucose , Seizures/diagnostic imaging , Tomography, Emission-Computed , Animals , Brain/metabolism , Deoxyglucose/analogs & derivatives , Deoxyglucose/metabolism , Epilepsies, Partial/chemically induced , Epilepsies, Partial/diagnostic imaging , Epilepsies, Partial/metabolism , Fluorodeoxyglucose F18 , Kainic Acid , Models, Biological , Papio , Seizures/chemically induced , Status Epilepticus/chemically induced , Status Epilepticus/diagnostic imagingABSTRACT
Local cerebral blood flow (CBF), oxygen consumption (CMRO2), and glucose utilization (CMR-Glc) have been measured in three patients by positron emission tomography (PET), together with continuous inhalation of oxygen-15-labeled gases and i.v. injection of [18F]fluoro-2-deoxy-D-glucose. In normal brain, the close local coupling between CBF and CMR-Glc, and that between CMRO2 and CMR-Glc, were well demonstrated. The coupling held for the asymptomatic areas and for parts of the affected hemispheres in two patients with cerebral ischemia. In one patient the CBF/CMR-Glc couple, but not the CMRO2/CMR-Glc couple, was disrupted in the acute ischemic core. This preliminary work demonstrates the local quantification of these important functional parameters, and indicates the potential usefulness of studying their pathophysiological interrelationship in brain disease.
Subject(s)
Brain Ischemia/diagnostic imaging , Brain/diagnostic imaging , Glucose/metabolism , Tomography, Emission-Computed/methods , Aged , Brain/metabolism , Cerebrovascular Circulation , Deoxyglucose/analogs & derivatives , Female , Fluorine , Fluorodeoxyglucose F18 , Humans , Male , Middle Aged , Oxygen Consumption , Oxygen Radioisotopes , RadioisotopesABSTRACT
To allow an additional approach to the study of brain metabolism in our laboratory, the synthesis of 18F-2-deoxy-2-fluoro-D-glucose (18FDG) has been adapted by the development of simple, reliable control techniques for routine use. By positron emission computed tomography, it has been established, in the baboon Papio papio, that there was a correlation between an epileptic focus and an increase in glucose incorporation. On the other hand, in man, a comparison between the local glucose utilization, cerebral blood flow and oxygen consumption has showed, in patients with ischaemic strokes, a disruption in the normal flow-metabolism couple.
