Objective

The aim of this study is to investigate changes in metabolic networks based on fluorodeoxyglucose positron emission tomography (FDG-PET) in patients with drug-resistant temporal lobe epilepsy (TLE) (with and without hippocampal sclerosis [HS]) when compared with healthy controls.

Methods

We retrospectively enrolled 30 patients with drug-resistant temporal lobe epilepsy (17 patients with HS and 13 patients without HS) and 39 healthy controls. All subjects underwent interictal FDG-PET scans, which were analyzed to obtain metabolic connectivity using graph theoretical analysis. We investigated the differences in metabolic connectivity between patients with drug-resistant TLE (with and without HS) and healthy controls.

Results

When compared with healthy controls, TLE patients with HS showed alterations of global and local metabolic connectivity. When considering global connectivity, TLE patients with HS had a decreased average degree with increased modularity. When considering local connectivity, TLE patients with HS displayed alterations of betweeness centrality in widespread regions. However, there were no alterations of global metabolic connectivity in TLE patients without HS when compared with healthy controls. In addition, when compared to TLE patients without HS, TLE patients with HS had increased modularity.

Significance

Our study demonstrates more severe alterations in metabolic networks based on FDG-PET in TLE patients with HS than in those without HS and healthy controls. This may represent distinct epileptic networks in TLE patients with HS versus those without HS, although both are drug-resistant focal epilepsy.

中文翻译：

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颞叶癫痫患者代谢网络的改变：使用 FDG-PET 的图论分析。

 客观的

本研究的目的是调查耐药颞叶癫痫 (TLE) 患者（伴或不伴海马硬化 [HS]）与健康对照者相比，基于氟脱氧葡萄糖正电子发射断层扫描 (FDG-PET) 的代谢网络变化。

 方法

我们回顾性纳入了 30 名耐药颞叶癫痫患者（17 名患有 HS 的患者和 13 名不患有 HS 的患者）和 39 名健康对照者。所有受试者均接受发作间期 FDG-PET 扫描，并使用图论分析获得代谢连通性。我们研究了耐药 TLE 患者（伴或不伴 HS）与健康对照之间代谢连通性的差异。

 结果

与健康对照相比，患有 HS 的 TLE 患者表现出整体和局部代谢连接的改变。当考虑全球连通性时，患有 HS 的 TLE 患者的平均程度降低，而模块性增加。当考虑局部连通性时，患有 HS 的 TLE 患者在广泛区域表现出介数中心性的改变。然而，与健康对照相比，没有 HS 的 TLE 患者的整体代谢连接没有改变。此外，与没有 HS 的 TLE 患者相比，患有 HS 的 TLE 患者的模块化程度有所提高。

 意义

我们的研究表明，与没有 HS 的患者和健康对照相比，患有 HS 的 TLE 患者基于 FDG-PET 的代谢网络发生更严重的改变。这可能代表了患有 HS 的 TLE 患者与不患有 HS 的 TLE 患者之间不同的癫痫网络，尽管两者都是耐药性局灶性癫痫。