Statistical voxel-wise analysis of ictal SPECT reveals pattern of abnormal perfusion in patients with temporal lobe epilepsy

Arq Neuropsiquiatr. 2005 Dec;63(4):977-83. doi: 10.1590/s0004-282x2005000600014. Epub 2005 Dec 15.

Abstract

Objective: To investigate the pattern of perfusion abnormalities in ictal and interictal brain perfusion SPECT images (BSI) from patients with temporal lobe epilepsy (TLE).

Method: It was acquired interictal and ictal BSI from 24 patients with refractory TLE. BSIs were analyzed by visual inspection and statistical parametric mapping (SPM2). Statistical analysis compared the patients group to a control group of 50 volunteers. The images from patients with left-TLE were left-right flipped.

Results: It was not observed significant perfusional differences in interictal scans with SPM. Ictal BSI in SPM analysis revealed hyperperfusion within ipsilateral temporal lobe (epileptogenic focus) and also contralateral parieto-occipital region, ipsilateral posterior cingulate gyrus, occipital lobes and ipsilateral basal ganglia. Ictal BSI also showed areas of hypoperfusion.

Conclusion: In a group analysis of ictal BSI of patients with TLE, voxel-wise analysis detects a network of distant regions of perfusional alteration which may play active role in seizure genesis and propagation.

MeSH terms

  • Adolescent
  • Adult
  • Brain / blood supply*
  • Brain / diagnostic imaging
  • Case-Control Studies
  • Cerebrovascular Circulation / physiology
  • Child
  • Child, Preschool
  • Chronic Disease
  • Data Interpretation, Statistical
  • Epilepsy, Temporal Lobe / diagnostic imaging*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Tomography, Emission-Computed, Single-Photon