Temporal lobe asymmetry in FDG-PET uptake predicts neuropsychological and seizure outcomes after temporal lobectomy |
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| Institution: | 1. Department of Neurology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA;2. Department of Radiology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA;3. Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, IA, USA;4. Department of Psychological and Quantitative Foundations, The University of Iowa, Iowa City, IA, USA;5. Department of Psychological and Brain Sciences, The University of Iowa, Iowa City, IA, USA;1. Section for Epidemiology, Department of Public Health, Aarhus University, Bartholins Allé 2, 8000 Aarhus C, Denmark;2. Research Unit for General Practice, Department of Public Health, Aarhus University, Bartholins Allé 2, 8000 Aarhus C, Denmark;3. Section for General Practice, Department of Public Health, Aarhus University, Bartholins Allé 2, 8000 Aarhus C, Denmark;4. Department of Neurology, Aarhus University Hospital, Nørrebrogade 44, 8000 Aarhus C, Denmark;1. University of Malta, Malta;2. President, International Bureau for Epilepsy 7 Priory Office Park, Stillorgan Road, Blackrock, Co. Dublin, Ireland;3. International Bureau for Epilepsy;1. Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN, USA;2. Program in Neuroscience, Indiana University, Bloomington, IN, USA;1. University of Washington Neurology Vocational Services Unit/Epilepsy Center, Department of Rehabilitation Medicine, Seattle, WA, United States;2. Surgical Epilepsy Program, California Pacific Medical Center, San Francisco, CA, United States;3. University of California, San Francisco, United States;4. Epilepsy Program, California Pacific Medical Center, San Francisco, CA, United States;5. PEP Jobs Program, California Pacific Medical Center, San Francisco, CA, United States;1. Department of Neuroanatomy, Institute of Zoology and Biomedical Research, Jagiellonian University, 9 Gronostajowa St., 30-387 Krakow, Poland;2. Department of Magnetic Resonance Imaging, Institute of Nuclear Physics Polish Academy of Sciences, Radzikowskiego 152 St, 31-342 Krakow, Poland |
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| Abstract: | ObjectiveThe objective of this study was to determine whether preoperative 18F]fludeoxyglucose (FDG)-positron emission tomography (PET) asymmetry in temporal lobe metabolism predicts neuropsychological and seizure outcomes after temporal lobectomy (TL).MethodsAn archival sample of 47 adults with unilateral temporal lobe epilepsy who underwent TL of their language-dominant (29 left, 1 right) or nondominant (17 right) hemisphere were administered neuropsychological measures pre- and postoperatively. Post-TL seizure outcomes were measured at 1 year. Regional FDG uptake values were defined by an automated technique, and a quantitative asymmetry index (AI) was calculated to represent the relative difference in the FDG uptake in the epileptic relative to the nonepileptic temporal lobe for four regions of interest: medial anterior temporal (MAT), lateral anterior temporal (LAT), medial posterior temporal (MPT), and lateral posterior temporal (LPT) cortices.ResultsIn language-dominant TL, naming outcomes were predicted by FDG uptake asymmetry in the MAT (r = − 0.38) and LPT (r = − 0.45) regions. For all patients, visual search and motor speed outcomes were predicted by FDG uptake asymmetry in all temporal regions (MPT, r = 0.42; MAT, r = 0.34; LPT, r = 0.47; LAT, r = 0.51). Seizure outcomes were predicted by FDG uptake asymmetry in the MAT (r = 0.36) and MPT (r = 0.30) regions. In all of these significant associations, greater hypometabolism in regions of the epileptic temporal lobe was associated with better postoperative outcomes.ConclusionsOur results support the conclusion that FDG uptake asymmetry is a useful clinical tool in assessing risk for cognitive changes in patients being considered for TL. |
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