OBJECTIVES: Experiments in animal models have identified specific subcortical anatomic circuits, which are critically involved in the pathogenesis and control of seizure activity. However, whether such anatomic substrates also exist in human epilepsy is not known. METHODS: We studied 2 separate groups of patients with focal epilepsies arising from any cortical location using either simultaneous EEG-fMRI (n = 19 patients) or [¹¹C]flumazenil PET (n = 18). RESULTS: Time-locked with the interictal epileptiform discharges, we found significant hemodynamic increases common to all patients near the frontal piriform cortex ipsilateral to the presumed cortical focus. GABA(A) receptor binding in the same area was reduced in patients with more frequent seizures. CONCLUSIONS: Our findings of cerebral blood flow and GABAergic changes, irrespective of where interictal or ictal activity occurs in the cortex, suggest that this area of the human primary olfactory cortex may be an attractive new target for epilepsy therapy, including neurosurgery, electrical stimulation, and focal drug delivery.
OBJECTIVES: Experiments in animal models have identified specific subcortical anatomic circuits, which are critically involved in the pathogenesis and control of seizure activity. However, whether such anatomic substrates also exist in human epilepsy is not known. METHODS: We studied 2 separate groups of patients with focal epilepsies arising from any cortical location using either simultaneous EEG-fMRI (n = 19 patients) or [¹¹C]flumazenil PET (n = 18). RESULTS: Time-locked with the interictal epileptiform discharges, we found significant hemodynamic increases common to all patients near the frontal piriform cortex ipsilateral to the presumed cortical focus. GABA(A) receptor binding in the same area was reduced in patients with more frequent seizures. CONCLUSIONS: Our findings of cerebral blood flow and GABAergic changes, irrespective of where interictal or ictal activity occurs in the cortex, suggest that this area of the human primary olfactory cortex may be an attractive new target for epilepsy therapy, including neurosurgery, electrical stimulation, and focal drug delivery.
Authors: J J Ekstrand; M E Domroese; D M Johnson; S L Feig; S M Knodel; M Behan; L B Haberly Journal: J Comp Neurol Date: 2001-06-04 Impact factor: 3.215
Authors: Hal Blumenfeld; Kelly A McNally; Susan D Vanderhill; A LeBron Paige; Richard Chung; Kathryn Davis; Andrew D Norden; Rik Stokking; Colin Studholme; Edward J Novotny; I George Zubal; Susan S Spencer Journal: Cereb Cortex Date: 2004-04-14 Impact factor: 5.357
Authors: Amir Omidvarnia; Mangor Pedersen; David N Vaughan; Jennifer M Walz; David F Abbott; Andrew Zalesky; Graeme D Jackson Journal: Hum Brain Mapp Date: 2017-07-24 Impact factor: 5.038
Authors: Marian Galovic; Irene Baudracco; Evan Wright-Goff; Galo Pillajo; Parashkev Nachev; Britta Wandschneider; Friedrich Woermann; Pamela Thompson; Sallie Baxendale; Andrew W McEvoy; Mark Nowell; Matteo Mancini; Sjoerd B Vos; Gavin P Winston; Rachel Sparks; Ferran Prados; Anna Miserocchi; Jane de Tisi; Louis André Van Graan; Roman Rodionov; Chengyuan Wu; Mahdi Alizadeh; Lauren Kozlowski; Ashwini D Sharan; Lohith G Kini; Kathryn A Davis; Brian Litt; Sebastien Ourselin; Solomon L Moshé; Josemir W A Sander; Wolfgang Löscher; John S Duncan; Matthias J Koepp Journal: JAMA Neurol Date: 2019-06-01 Impact factor: 18.302