Journal Article

Seizure-related short-term plasticity of benzodiazepine receptors in partial epilepsy: a [<sup>11</sup>C]flumazenil-PET study

Sandrine Bouvard, Nicolas Costes, Frédéric Bonnefoi, Franck Lavenne, François Mauguière, Jacques Delforge and Philippe Ryvlin

in Brain

Published on behalf of The Guarantors of Brain

Volume 128, issue 6, pages 1330-1343
Published in print June 2005 | ISSN: 0006-8950
Published online March 2005 | e-ISSN: 1460-2156 | DOI: http://dx.doi.org/10.1093/brain/awh470
Seizure-related short-term plasticity of benzodiazepine receptors in partial epilepsy: a [11C]flumazenil-PET study

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We have undertaken a test–re-test [11C]flumazenil (FMZ) PET study in 10 drug-resistant epileptic patients, including six with a mesiotemporal epilepsy (MTE), and 10 normal controls, in order to investigate seizure-related short-term plasticity of benzodiazepine (BZD) receptors. All subjects underwent two FMZ-PET scans at a 1 week interval. Patients benefited from a concurrent video-EEG monitoring which allowed determination of the duration of the interictal period (IP) preceding each PET. Test–re-test whole brain B′max variations, evaluated with a partial-saturation injection protocol, were similarly observed in patients and controls, suggesting a physiological modulation of BZD receptors. Five patients (50%), but no controls, also demonstrated clinically significant test–re-test FMZ-PET variations in the mesial temporal region. This was observed in all three patients with MTE and no hippocampal atrophy in whom only the PET study associated with the shortest IP correctly identified the epileptogenic zone. Statistical analysis revealed a significant effect of IP duration on BZD receptor B′max in MTE patients, suggesting that the shorter the IP, the lower the B′max in the epileptogenic hippocampus. FMZ-PET appears to be an interesting tool for investigating both normal and abnormal short-term modulations of the BZD receptor system, and should ideally be performed within a few days following a seizure in patients with MTE and a normal MRI.

Keywords: epilepsy; PET; flumazenil; benzodiazepine receptors; hippocampus; BZD = benzodiazepine; FMZ = flumazenil; IP = interictal period; MTE = mesiotemporal epilepsy; ROI = region of interest; SPM = statistical parametric mapping; TLE = temporal lobe epilepsy

Journal Article.  8771 words.  Illustrated.

Subjects: Neurology ; Neuroscience

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