Backgroud : To examine the predictability of regional cerebral glucose metabolism in determining Wada memory dominance and lateralizing epileptic focus. METHODS: 1 8 F-fluorodeoxyglucose positron emission tomography (FDG-PET) and Wada test were performed in 18 patients with temporal lobe epilepsy (TLE). Regions of interest were determined in mesial, polar, anterior-lateral, mid-lateral, and posterior-lateral regions of the temporal lobe. The asymmetry indices of FDG-PET (PET-AI) were calculated in each ROI of temporal lobe, and those of Wada memory test (Wada-AI) were obtained as well. RESULTS: Pearson correlation coefficient showed Wada-AI was significantly correlated with PET-AI in mesial (r=0.67, p=0.001), polar (r=0.55, p=0.010), anterior-lateral (0.55, p=0.009) and mid-lateral (r=0.51, p=0.016) temporal regions. However, after simple linear regression analysis, PET-AI of mesial temporal region alone was significantly correlated with Wada-AI (p=0.008). In localizing epileptic focus, Wada-AI could correctly lateralize the seizure focus in 90% of the left TLE and 75% of the right TLE patients. No false lateralization by Wada-AI was observed except two patients showing prolonged confusion after amobarbital injection who were not included in this study. The PET-AI of the mesial temporal region showed the highest sensitivity of seizure lateralization (100% of left TLE and 87.5% of right RLE). CONCLUSIONS: Although FDG-PET hypometabolism is observed both at mesial and lateral regions of the temporal lobe in mesial TLE, mesial temporal region appeared to be a dominant and leading area for lateralizing Wada memory dominance and epileptic focus.
Amobarbital ; Epilepsy, Temporal Lobe* ; Glucose ; Humans ; Linear Models ; Memory* ; Metabolism ; Positron-Emission Tomography ; Seizures ; Temporal Lobe*

PURPOSE: We investigated the difference of glucose metabolism of medial and lateral temporal lobes of patients with temporal lobe epilepsy (TLE) utilizing quantitative comparison of regional metabolic activities using asymmetric index. MATERIALS AND METHODS: We studied 19 pathologically proven mesial TLE and 25 lateral TLE patients. Lateral TLE patients were either normal on magnetic resonance imaging (cryptogenic: n=14) or had structural lesions (lesional: n=11). Asymmetric index (ASI) was calculated as [(ipsilateral-contralateral)/(ipsilateral+ contralateral)]x200. RESULTS: ASI of medial and lateral lobes of mesial TLE was decreased (-16.4+/-8.3 and -12.7+/-5.5, respectively). In cryptogenic lateral TLE, ASI of lateral temporal lobe was decreased (-11.8+/-4.7), whereas that of medial temporal lobe was not decreased (-4.6+/-6.3). ASI of medial lobe of lesional lateral TLE was -7.3+/-9.1, which was significantly different from that of mesial TLE (p<0.05). Patients with lesional lateral TLE had evident metabolic defects or decrease (ASI: -22+/-10.5) in lateral temporal lobe. While we could not find the difference of metabolic activity in lateral temporal lobes between cryptogenic lateral TLE and mesial TLE patients, the difference of metabolic activity was significant in medial temporal lobes which was revealed by ASI quantitation. CONCLUSION: Asymmetric decrease of metabolic activity in both medial and lateral temporal lobes indicates medial temporal epilepsy. Symmetry of metabolic activity in medial temporal lobe combined with asymmetry of that in lateral temporal lobe may give hints that the epileptogenic zone is lateral.
Epilepsy ; Epilepsy, Temporal Lobe* ; Glucose* ; Humans ; Magnetic Resonance Imaging ; Metabolism* ; Temporal Lobe*

BACKGROUND: To investigate postoperative changes in the cerebral glucose metabolism of patients with mesial temporal lobe epilepsy (MTLE), statistical parametric mapping (SPM) analysis was performed on pre- and post-operative 18F-fluorodeoxy glucose positron emission tomographic (FDG-PET) images. METHODS: We included 28 patients with MTLE who had under-gone surgery and had been seizure free postoperatively (16 had left MTLE and 12 right MTLE). All patients showed hippocampal sclerosis by pathology or brain MRI. FDG-PET images of the 12 right TLE patients were reversed to lateralize the epileptogenic zone to the left side in all patients. RESULTS: Application of the paired t-test in SPM to pre- and postoperative FDG-PETs showed that the postoperative glucose metabolism decreased in the caudate nucleus, pulvinar of thalamus, fusiform gyrus, lingual gyrus, and in the posterior region of the insular cortex in the hemisphere ipsilateral to resection, whereas postoperative glucose metabolism increased in the anterior region of the insular cortex, temporal stem white matter, midbrain, inferior precentral gyrus, anterior cingulate gyrus, and supramarginal gyrus in the hemisphere ipsilateral to resection. No significant postsurgical changes of cerebral glucose metabolism occurred in the contralateral hemisphere. Subtraction between pre- and postoperative FDG-PET images in individual patients produced similar findings to the SPM results. CONCLUSION: This study suggests that brain regions showing a postoperative increase in glucose metabolism appear to represent the propagation pathways of ictal and interictal epileptic discharges in MTLE while a postoperative decrease in glucose metabolism may be related to a permanent loss of afferents from resected anterior-mesial temporal structures.
Anterior Temporal Lobectomy ; Brain ; Caudate Nucleus ; Electrons ; Epilepsy, Temporal Lobe* ; Glucose ; Gyrus Cinguli ; Humans ; Magnetic Resonance Imaging ; Mesencephalon ; Metabolism ; Pathology ; Pulvinar ; Sclerosis ; Seizures ; Temporal Lobe* ; Thalamus

OBJECTIVE: To investigate the axonal sprouting of somatostatin(SS) positive interneurons in temporal lobe epilepsy. METHODS: 6-8 week-old healthy male SD rats were divided randomly into an epileptic group (treated by lithium and pilocarpine intraperitoneal injection) and a control group (by lithium and normal sodium intraperitoneal injection). Each group was randomly divided into 5 subgroups at 1,7,15,30, amd 60 d after the injection. Immunohistochemistry method was used to detect the number changes of SS or neuronal nuclei (NeuN) positive neurons in different domains of the hippocampus at different time points in each group, and the coexpression of SS positive interneurons combined with NeuN was detected by double immunofluorescence to observe the dynamic changes and axonal sprouting of SS positive interneurons. RESULTS: The number of SS neurons in the experimental group exceeded that in the control group in the CA1 area at 60 d post-status epileptieus SE (P<0.01), and numerous SS positive fibers were seen throughout the layers of the CAl area at 60 d post-SE. NeuN positive neurons in the stratum oriens and stratum radiatum layers in the initiation site of the CA1 area were beyond normal at 60 d post-SE. The number of double labeled SS interneurons gradually rose at 15 d in stratum oriens of CA1, and even exceeded that of the controls in the stratum oriens and stratum radiatum layers of CA1 at 60 d. CONCLUSION The numerous SS positive fibers throughout the layers of the CAl area at 60 d post-SE come from the increased interneurons in the stratum oriens and stratum radiatum layers of CA1 area. The pathological axonal sprouting may play an important role in the generation and compensation of temporal lobe epilepsy.
Animals ; Axons ; metabolism ; pathology ; CA1 Region, Hippocampal ; cytology ; metabolism ; physiopathology ; Efferent Pathways ; pathology ; physiology ; Epilepsy, Temporal Lobe ; chemically induced ; metabolism ; physiopathology ; Interneurons ; cytology ; metabolism ; pathology ; Male ; Pilocarpine ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Somatostatin ; metabolism ; Temporal Lobe ; metabolism

Objective: To investigate clinicopathological features of multinodular and vacuolar neurodegenerative tumor (MVNT) of the cerebrum, and to investigate its immunophenotype, molecular characteristics and prognosis. Methods: Four cases were collected at the General Hospital of Southern Theater Command, Guangzhou, China and one case was collected at the First People's Hospital of Huizhou, China from 2013 to 2021. Clinical, histological, immunohistochemical and molecular characteristics of these five cases were analyzed. Follow-up was carried out to evaluate their prognoses. Results: There were four females and one male, with an average age of 42 years (range, 17 to 51 years). Four patients presented with seizures, while one presented with discomfort on the head. Pre-operative imaging demonstrated non-enhancing, T2-hyperintense multinodular lesions in the deep cortex and superficial white matter of the frontal (n=1) or temporal lobes (n=4). Microscopically, the tumor cells were mostly arranged in discrete and coalescent nodules primarily within the deep cortical ribbon and superficial subcortical white matter. The tumors were composed of large cells with ganglionic morphology, vesicular nuclei, prominent nucleoli and amphophilic or lightly basophilic cytoplasm. They exhibited varying degrees of matrix vacuolization. Vacuolated tumor cells did not show overt cellular atypia or any mitotic activities. Immunohistochemically, tumor cells exhibited widespread nuclear staining for the HuC/HuD neuronal antigens, SOX10 and Olig2. Expression of other neuronal markers, including synaptophysin, neurofilament and MAP2, was patchy to absent. The tumor cells were negative for NeuN, GFAP, p53, H3K27M, IDH1 R132H, ATRX, BRG1, INI1 and BRAF V600E. No aberrant molecular changes were identified in case 3 and case 5 using next-generation sequencing (including 131 genes related to diagnosis and prognosis of central nervous system tumors). All patients underwent complete or substantial tumor excision without adjuvant chemoradiotherapy. Post-operative follow-up information over intervals of 6 months to 8 years was available for five patients. All patients were free of recurrence. Conclusions: MVNT is an indolent tumor, mostly affecting adults, which supports classifying MVNT as WHO grade 1. There is no tumor recurrence even in the patients treated with subtotal surgical excision. MVNTs may be considered for observation or non-surgical treatments if they are asymptomatic.
Adult ; Female ; Humans ; Male ; Brain Neoplasms/pathology* ; Cerebrum/pathology* ; Neurons/metabolism* ; Seizures ; Temporal Lobe/pathology* ; Biomarkers, Tumor/metabolism*

Parvalbumin interneurons belong to the major types of GABAergic interneurons. Although the distribution and pathological alterations of parvalbumin interneuron somata have been widely studied, the distribution and vulnerability of the neurites and fibers extending from parvalbumin interneurons have not been detailly interrogated. Through the Cre recombinase-reporter system, we visualized parvalbumin-positive fibers and thoroughly investigated their spatial distribution in the mouse brain. We found that parvalbumin fibers are widely distributed in the brain with specific morphological characteristics in different regions, among which the cortex and thalamus exhibited the most intense parvalbumin signals. In regions such as the striatum and optic tract, even long-range thick parvalbumin projections were detected. Furthermore, in mouse models of temporal lobe epilepsy and Parkinson's disease, parvalbumin fibers suffered both massive and subtle morphological alterations. Our study provides an overview of parvalbumin fibers in the brain and emphasizes the potential pathological implications of parvalbumin fiber alterations.
Mice ; Animals ; Epilepsy, Temporal Lobe/pathology* ; Parvalbumins/metabolism* ; Parkinson Disease/pathology* ; Neurons/metabolism* ; Interneurons/physiology* ; Disease Models, Animal ; Brain/pathology*

OBJECTIVETo explore the role of beta-catenin in the pathogenesis of mesial temporal lobe epilepsy.

METHODSKainic acid-induced rat models of medial temporal lobe epilepsy was established. The expression of beta-catenin in the normal mice and the model mice were detected using Western blot analysis. The expression of beta-catenin at human hippocampus was detected using immunohistochemical analysis and immunofluorescence and compared between patients with non-hippocampal sclerosis temporal lobe epilepsy and those with hippocampal sclerosis epilepsy.

RESULTSThe pathologies of model mice were similar with those in mice with hippocampal sclerosis temporal lobe epilepsy, demonstrating that the mice model was successfully established. Western blot analysis showed no significant difference of beta-catenin expression between normal mice and model mice. As shown by immunohistochemical analysis and immunofluorescence, beta-catenin expression in human hippocampus was also not significantly different between patients with temporal lobe epilepsy without hippocampal sclerosis and those with hippocampal sclerosis.

CONCLUSIONBeta-catenin may not be involved in the development of hippocampal sclerosis of mesial temporal lobe epilepsy.

Animals ; Disease Models, Animal ; Epilepsy, Temporal Lobe ; metabolism ; pathology ; Male ; Mice ; Mice, Inbred C57BL ; beta Catenin ; metabolism

Objective To explore the temporal and spatial distribution of CCAAT/enhancer-binding protein homologous protein (CHOP) and calnexin (CNX) in the dentate gyrus of mesial temporal lobe epilepsy (mTLE) mouse model. Methods We used kainic acid (KA) to induce acute phase (12 h and 24 h) mTLE mouse models and performed Western blotting and immunofluorescence to detect the different expressions and distribution pattern of CHOP and CNX in CA3 of the hippocampus. Results Compared with the controls,the expressions of CHOP(F=1.136,P=0.4069) and CNX (F=2.378,P=0.2087) did not increase in CA3 of hippocampus 12 h following KA injection in the acute phase of mTLE mouse models,whereas the expressions in CA1 and CA3 of hippocampus 24 h after injection were significantly higher (F=8.510,P=0.0362;F=6.968,P=0.0497,respectively). As shown by immunofluorescence analysis,CHOP was expressed mainly in CA3 of hippocampus 12 h after KA injection,and increased in CA1 and CA3 24 h after KA administration. Compared with the controls,the expressions of CHOP(F=24.480,P=0.0057) and CNX (F=7.149,P=0.0478) were significantly higher 24 h after KA injection.Conclusions The expression of CHOP increases along with the progression of seizures,indicating the increased level of endoplasmic reticulum stress. An increasing number of CNX,which serves as molecular chaperone,may be needed to facilitate the unfolded protein to complete the folding process.
Animals ; Calnexin ; metabolism ; Dentate Gyrus ; metabolism ; Disease Models, Animal ; Epilepsy, Temporal Lobe ; chemically induced ; metabolism ; Kainic Acid ; Mice ; Seizures ; chemically induced ; metabolism ; Transcription Factor CHOP ; metabolism

OBJECTIVETo explore the temporal and spatial distribution of growth-associated protein 43(GAP-43)and phosphorylated growth-associated protein 43(p-GAP-43)in the dentate gyrus of mesial temporal lobe epilepsy(MTLE)mouse model.

METHODSMTLE mouse model was established by using the kainic acid(KA)induction. Immunohistochemistry and Western blotting were applied to detect the expressions of GAP-43 and p-GAP-43 in different stages of epileptogenesis.

RESULTSBoth in the epileptic and control mice, high GAP-43 expression level was detected in the dentate gyrus, hilus, and inner molecular layer of hippocampus. Decreased p-GAP-43 expression was detected 5 days, 2 weeks, and 5 weeks after KA-induced seizures.

CONCLUSIONThe decreased p-GAP-43 expression in the duration of seizure may play an important role in the synaptic reorganization of the sclerotic hippocampus.

Animals ; Dentate Gyrus ; metabolism ; Disease Models, Animal ; Epilepsy ; Epilepsy, Temporal Lobe ; metabolism ; GAP-43 Protein ; metabolism ; Hippocampus ; metabolism ; Kainic Acid ; Mice ; Seizures

Brain Neoplasms ; metabolism ; pathology ; surgery ; Diagnosis, Differential ; Humans ; Infant ; Magnetic Resonance Imaging ; Male ; Neoplasm Recurrence, Local ; Nestin ; metabolism ; Neuroectodermal Tumors, Primitive ; metabolism ; pathology ; surgery ; Temporal Lobe ; Vimentin ; metabolism