Guoguang Zhao1, Jie Lu2,3,4, Yaqin Hou5, Kun Guo5, Xiaotong Fan6, Kun Shang5, Jingjuan Wang5, Zhenming Wang7, Yongzhi Shan6. 1. Department of Neurosurgery, China INI, Xuanwu Hospital, Capital Medical University, No. 45 Changchun Street, Xicheng District, Beijing, 100053, China. ggzhao@vip.sina.com. 2. Department of Nuclear Medicine, Xuanwu Hospital, Capital Medical University, No. 45 Changchun Street, Xicheng District, Beijing, 100053, China. imaginglu@hotmail.com. 3. Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing, China. imaginglu@hotmail.com. 4. Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing, China. imaginglu@hotmail.com. 5. Department of Nuclear Medicine, Xuanwu Hospital, Capital Medical University, No. 45 Changchun Street, Xicheng District, Beijing, 100053, China. 6. Department of Neurosurgery, China INI, Xuanwu Hospital, Capital Medical University, No. 45 Changchun Street, Xicheng District, Beijing, 100053, China. 7. Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing, China.
Abstract
PURPOSE: Crossed cerebellar diaschisis (CCD) has been widely studied in hemispheric stroke but is less characterized in epilepsy. In this study, we used 18F-FDG PET/CT to investigate the risk factors for CCD and its prognostic value for intractable epilepsy caused by focal cortical dysplasia (FCD). METHODS: One hundred medically intractable epilepsy patients pathologically diagnosed with FCD postoperatively were included and classified into two groups: CCD+ and CCD-. PET/CT images were analyzed qualitatively by visual assessment and semi-quantitatively using the absolute asymmetry index (|AI|). Clinical factors, including age, sex, body mass index (BMI), age at seizure onset, epilepsy duration, seizure type, seizure frequency, electroencephalography (EEG) and brain magnetic resonance imaging (MRI), were retrospectively assessed from medical records. Follow-up outcomes were evaluated according to the Engel classification at 3, 6, 12, 24 and 36 months postoperatively. RESULTS: Of the 100 patients, 77 (77.0%) were classified as CCD-, and 23 (23.0%) were classified as CCD + . CCD+ patients had a higher number of lobes involved on PET (3.61 ± 2.16 vs 2.26 ± 1.01, P < 0.001) than CCD- patients. CCD- patients showed more negative MRI results than CCD + patients (P = 0.02). At 12 months postoperatively, 70.7% (29/41) of CCD- patients and 30.8% (4/13) of CCD + patients presented a favourable prognosis (P = 0.02). Significant differences in the average |AI| values in the posterior frontal and anterior temporal lobes were found between CCD+ and CCD- patients (P < 0.05). CONCLUSION: The number of lobes involved on PET, structural anomalies on MRI, the |AI| values in the posterior frontal and anterior temporal lobes may be predisposing factors for CCD. CCD occurrence may help predict the prognosis of FCD patients at 12 months postoperatively.
PURPOSE:Crossed cerebellar diaschisis (CCD) has been widely studied in hemispheric stroke but is less characterized in epilepsy. In this study, we used 18F-FDG PET/CT to investigate the risk factors for CCD and its prognostic value for intractable epilepsy caused by focal cortical dysplasia (FCD). METHODS: One hundred medically intractable epilepsypatients pathologically diagnosed with FCD postoperatively were included and classified into two groups: CCD+ and CCD-. PET/CT images were analyzed qualitatively by visual assessment and semi-quantitatively using the absolute asymmetry index (|AI|). Clinical factors, including age, sex, body mass index (BMI), age at seizure onset, epilepsy duration, seizure type, seizure frequency, electroencephalography (EEG) and brain magnetic resonance imaging (MRI), were retrospectively assessed from medical records. Follow-up outcomes were evaluated according to the Engel classification at 3, 6, 12, 24 and 36 months postoperatively. RESULTS: Of the 100 patients, 77 (77.0%) were classified as CCD-, and 23 (23.0%) were classified as CCD + . CCD+ patients had a higher number of lobes involved on PET (3.61 ± 2.16 vs 2.26 ± 1.01, P < 0.001) than CCD- patients. CCD- patients showed more negative MRI results than CCD + patients (P = 0.02). At 12 months postoperatively, 70.7% (29/41) of CCD- patients and 30.8% (4/13) of CCD + patients presented a favourable prognosis (P = 0.02). Significant differences in the average |AI| values in the posterior frontal and anterior temporal lobes were found between CCD+ and CCD- patients (P < 0.05). CONCLUSION: The number of lobes involved on PET, structural anomalies on MRI, the |AI| values in the posterior frontal and anterior temporal lobes may be predisposing factors for CCD. CCD occurrence may help predict the prognosis of FCDpatients at 12 months postoperatively.
Authors: H G Wieser; W T Blume; D Fish; E Goldensohn; A Hufnagel; D King; M R Sperling; H Lüders; T A Pedley Journal: Epilepsia Date: 2001-02 Impact factor: 5.864
Authors: H J Biersack; D Linke; F Brassel; K Reichmann; M Kurthen; H F Durwen; B M Reuter; J Wappenschmidt; H Stefan Journal: J Nucl Med Date: 1987-11 Impact factor: 10.057
Authors: Bixiao Cui; Yi Shan; Tianhao Zhang; Yan Ma; Bin Yang; Hongwei Yang; Liqun Jiao; Baoci Shan; Jie Lu Journal: Ann Nucl Med Date: 2022-07-05 Impact factor: 2.258