Benzodiazepine receptors and cerebral blood flow in partial epilepsy |
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Authors: | Peter Bartenstein Albert Ludolph Otmar Schober Gerhard Lottes Klemens Scheidhauer Joachim Sciuk Hans-Frieder Beer |
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Institution: | (1) Department of Nuclear Medicine, University of Münster, Albert-Schweitzer-Strasse 33,D-4400, Münster, Federal Republic of Germany;(2) Department of Neurology, University of Münster, Albert-Schweitzer-Strasse 33, D-4400, Münster, Federal Republic of Germany;(3) Paul Scherrer Institut Villingen, Switzerland |
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Abstract: | It was the aim of this study to compare benzodiazepine (Bz) receptor binding and cerebral perfusion in patients with partial epilepsy. Single photon emission tomography (SPET) studies with the flow-marker technetium 99m hexamethylpropylene amine oxine (99mTc-HMPAO) and with the123I-labelled Bz-receptor ligand Ro 16-0154 (123I-Iomazenil) were performed in 12 patients with partial epilepsy, all with normal magnetic resonance imaging (MRI) and computed tomography (CT) scans. The SPET studies with123I-Iomazenil were carried out 5 min and 2 h after injection. At 2 h the distribution of activity was very similar to the expected distribution of Bz-receptors in the human brain, known from positron emission tomography (PET) work and post-mortem studies. Early images showed a significantly higher tracer accumulation in the area of the basal ganglia, cerebellum, and naso-pharyngeal space. This finding is caused by non-specific binding and the contribution of the tracer in the blood pool in this phase. Also after 2 h p.i. of123I-Iomazenil, 9 of the 12 patients showed a focal decrease of of Bz-receptor binding. Ten patients had focal flow abnormalities with99mTc-HMPAO SPET. In 8 subjects impairment of flow was seen in sites of reduced123I-Iomazenil uptake.123I-Io-mazenil is suitable for Bz-receptor mapping. In this series of patients, Bz-receptor mapping with SPET seems to offer no advantage over99mTc-HMPAO in the detection of epileptic foci.
Offprint requests to: P. Bartenstein |
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Keywords: | Partial epilepsy SPET Benzodiazepine receptors |
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