Research Mentor Name

Csaba Juhasz

Research Mentor Email Address

csaba.juhasz@wayne.edu

Institution / Department

Wayne State University, Pediatrics, Neurology and Neurosurgery

Document Type

Research Abstract

Research Type

clinicalresearch

Graduate Level Research

no

Abstract

Background

Fluorodeoxyglucose Positron Emission Tomography (FDG-PET) is often used during presurgical evaluation of drug-resistant epilepsies. Interictal glucose hypometabolism can involve the thalamus ipsilateral to the epileptic focus. As targeted stimulation of specific thalamic nuclei is increasingly utilized to control seizures, analysis of intrathalamic variations of metabolic abnormalities may help identify the optimal target and monitor treatment effects.

Methods

FDG-PET scans performed on a high-resolution PET scanner were used to measure glucose uptake in 12 patients (median age: 27.5 years) ipsi- and contralateral to the epileptic focus in the whole thalamus and five thalamic regions (dorsomedial, lateral, anterior, superior nuclei, and pulvinar), as well as the lentiform nucleus. Ipsilateral/contralateral (IC) metabolic ratios of ≤0.90 were defined as ipsilateral hypometabolism. Spearman’s rank correlations were performed to evaluate associations between age and regional IC ratios.

Results

While the whole thalamus showed decreased ipsilateral metabolism in only two patients, at least one thalamic region was hypometabolic in 8 (67%) subjects, including 5 in the pulvinar, 3 in the anterior and superior nuclei, and 1 each in the dorsomedial and lateral thalamus, as well as the lentiform nucleus. Age was inversely correlated with anterior thalamic (r=–0.76, p=0.004) and lentiform nucleus IC ratios (r=–0.67, p=0.017).

Conclusion

Thalamic subregions are differentially affected in patients with focal epilepsy. The age-related metabolic decrease in the anterior thalamus, a common target for thalamic stimulation, suggests a progressive metabolic decline. High-resolution PET may help identify potential patient-specific regions for targeted stimulation to improve seizure control in drug-resistant epilepsy.

Disciplines

Medicine and Health Sciences

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