Neuropsychological functioning and brain energetics of drug resistant mesial temporal lobe epilepsy patients

Epilepsy Res. 2017 Dec:138:26-31. doi: 10.1016/j.eplepsyres.2017.10.009. Epub 2017 Oct 12.

Abstract

Interictal hypometabolism is commonly measured by 18-fluoro-deoxyglucose Positron Emission Tomography (FDG-PET) in the temporal lobe of patients with mesial temporal lobe epilepsy (MTLE-HS). Left temporal lobe interictal FDG-PET hypometabolism has been associated with verbal memory impairment, while right temporal lobe FDG-PET hypometabolism is associated with nonverbal memory impairment. The biochemical mechanisms involved in these findings remain unknown. In comparison to healthy controls (n=21), surgically treated patients with MTLE-HS (n=32, left side=17) had significant lower scores in the Rey Auditory Verbal Learning Test (RAVLT retention and delayed), Logical Memory II (LMII), Boston Naming test (BNT), Letter Fluency and Category Fluency. We investigated whether enzymatic activities of the mitochondrial enzymes Complex I (C I), Complex II (C II), Complex IV (C IV) and Succinate Dehydrogenase (SDH) from the resected samples of the middle temporal neocortex (mTCx), amygdala (AMY) and hippocampus (HIP) were associated with performance in the RAVLT, LMII, BNT and fluency tests of our patients. After controlling for the side of hippocampus sclerosis, years of education, disease duration, antiepileptic treatment and seizure outcome after surgery, no independent associations were observed between the cognitive test scores and the analyzed mitochondrial enzymatic activities (p>0.37). Results indicate that memory and language impairment observed in MTLE-HS patients are not strongly associated with the levels of mitochondrial CI, CII, SDH and C IV enzymatic activities in the temporal lobe structures ipsilateral to the HS lesion.

Keywords: Brain metabolism; Cognition; Hippocampus; Temporal lobe epilepsy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anticonvulsants / therapeutic use
  • Brain / diagnostic imaging
  • Brain / metabolism*
  • Drug Resistant Epilepsy / complications
  • Drug Resistant Epilepsy / diagnostic imaging
  • Drug Resistant Epilepsy / pathology
  • Electroencephalography
  • Epilepsy, Temporal Lobe / complications*
  • Epilepsy, Temporal Lobe / diagnostic imaging
  • Epilepsy, Temporal Lobe / drug therapy
  • Epilepsy, Temporal Lobe / pathology*
  • Female
  • Fluorodeoxyglucose F18
  • Humans
  • Male
  • Memory Disorders / diagnostic imaging
  • Memory Disorders / etiology*
  • Multienzyme Complexes / metabolism*
  • Neuropsychological Tests
  • Positron-Emission Tomography
  • Statistics, Nonparametric

Substances

  • Anticonvulsants
  • Multienzyme Complexes
  • Fluorodeoxyglucose F18