J Nucl Med. 2007; 48 (Supplement 2):254P
Neurosciences: Neurology
Neurology Posters |
SPECT evaluation of extrahippocampal benzodiazepine receptor density in the patients with hippocampal sclerosis
Koichiro Kaneko1,
Hirofumi Koga1,
Koichiro Abe1,
Horofumi Sawamoto1,
Takashi Yoshiura1,
Takato Morioka2,
Masayuki Sasaki3 and
Hiroshi Honda1
1 Clinical Radiology; ;
2 Neurosurgery; ;
3 Laboratory of Molecular Imaging Sciences, Kyushu University, Fukuoka, Japan
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Objectives: The aim of this study was to evaluate extrahippocampal benzodiazepine receptor (BZR) density in patients with hippocampal sclerosis and to clarify the relationship between extrahippocampal BZR density and post-surgical outcome. Methods: The subjects were 13 hippocampal sclerosis patients (M/F=7/6, mean age=28 years), and 123I-Iomazenil SPECT was performed before surgery in all patients. IMZ SPECT images were compared with those of 18 normal healthy subjects (M/F=11/7, mean age=26 years) using 3D-SSP. Then, Z-score maps those showed decreased BZR density were obtained. In each Z-score map, ROIs were placed on entire region of frontal, temporal, occipital, parietal lobes and limbic systems on both sides. We measured the area of decreased BZR density (Z-score > 3.0), and compared with post-surgical outcome according to Engel classification (good outcome = class, poor outcome = class
or more). Results: Overall, BZR density was most widely decreased in the ipsilateral temporal lobe (11.3±7.1%), and this was significantly larger than that of contralateral temporal lobe (6.8±5.0%) (p < 0.05). Other region showed no definite laterality. In patients with poor outcome (n=4), decreased BZR density area was significantly larger in ipsilateral (15.1±5.8%) and contralateral temporal lobe (11.9±5.7%) than those of patients with good outcome (8.1±4.5% and 4.8±3.2%, respectively) (n=9) (p < 0.05). In other regions excluding limbic systems, patients with poor outcome tend to have larger decreased BZR density area than patients with good outcome, although they were not statistically significant. Conclusions: In patients with hippocampal sclerosis, decreased BZR density was observed in extrahippocampal region especially in the ipsilateral temporal lobe, and this was correlated with post-surgical outcome. This result showed that IMZ-SPECT possible to be useful to predict post-surgical outcomes in patients with hippocampal sclerosis.
