Czy epilepsja płata skroniowego jest chorobą postępującą? Analiza zmian receptorów serotoniny
Is temporal lobe epilepsy a progressive disease? Insights from a 5-HT receptor partial volume correction study
W skrócie
Badacze badali 22 pacjentów z epilepsją płata skroniowego, aby sprawdzić, czy choroba pogarsza się z czasem. Odkryli, że u pacjentów z określonym uszkodzeniem mózgu (stwardnieniem hipokampa) liczba receptorów serotoniny zmniejszała się wraz z czasem trwania choroby. Wyniki sugerują, że u niektórych pacjentów epilepsja rzeczywiście może być chorobą, która się pogarsza, prowadząc do utraty komórek mózgowych odpowiedzialnych za działanie serotoniny.
Oryginalny abstract (angielski)
BACKGROUND AND OBJECTIVES: Clinical, magnetic resonance (MR) and [F]fluorodeoxyglucose positron emission tomography (PET) studies suggest that temporal lobe epilepsy (TLE) might be a progressive disease. Whether epilepsy progression affects 5-HT receptor concentration is still unknown. METHODS: We used PET with the 5-HT ligand [F]FCWAY in 22 TLE patients. Dynamic frames were acquired for 120-min and modeled with a simplified 3-parameter 2-tissue compartment. An automated, MR-segmentation-based partial volume correction (PVC) algorithm was applied. Contralateral-ipsilateral asymmetry indices (AI) of the binding potential (BP = (V-V)/f) were measured and the effects of epilepsy duration and MR findings were assessed. RESULTS: In the whole group, there was no significant (P > 0.05) correlation between epilepsy duration and AI in any region. However, in the subgroup of patients (n = 16) with mesial temporal sclerosis (MTS) a significant positive relationship between epilepsy duration and AI was found in hippocampus and parahippocampus. Patients with MTS had significantly greater hippocampus AI than patients with normal MR. CONCLUSION: Our results further support the hypothesis that in a subset of patients epilepsy might be 'progressive' by first showing significant correlations between epilepsy duration and 5-HT receptor concentration in hippocampus and parahippocampus of TLE patients with MTS. Loss of 5-HT receptors exceeds loss of gray matter because the relationship between epilepsy duration and 5-HT receptor concentration persists after PVC.