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Brain FDG‐PET findings in glutamic acid decarboxylase antibody‐associated epilepsy
Author(s) -
MongayOchoa Neus,
SalaPadró Jacint,
ReynésLlompart Gabriel,
RodríguezBel Laura,
Jaraba Sònia,
Morandeira Francisco,
Falip Mercè
Publication year - 2021
Publication title -
journal of neuroimaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.822
H-Index - 64
eISSN - 1552-6569
pISSN - 1051-2284
DOI - 10.1111/jon.12874
Subject(s) - hippocampal sclerosis , glutamate decarboxylase , medicine , epilepsy , temporal lobe , pathology , biology , psychiatry , biochemistry , enzyme
Background and Purpose Glutamic acid decarboxylase antibodies (GAD‐Ab) are sometimes associated with chronic drug‐resistant focal epilepsy. Clinically, it may manifest as mesial temporal lobe epilepsy (mTLE), with GAD‐Ab patients difficult to distinguish. Therefore, the aim of this study is to compare brain metabolism of patients with mTLE and high serum titers of GAD‐Ab (>2000 UI/ml) to those with mTLE and hippocampal sclerosis (HS) and confirmed GAD‐ab negativity. Methods Images from PET studies were normalized to an SPM 12 template. Voxel to voxel comparisons were made using a two‐sample one‐tailed t ‐test. Results In both patients with GAD‐Ab and controls (mTLE‐HS), hypometabolism in mesial temporal lobe areas was observed. When comparing the two groups, GAD‐Ab patients had statistically significant reduced metabolism in both insulae and medial inferior frontal‐hypothalamus area ( p < 0.001). Conclusions Hypometabolism in mesial temporal lobe areas together with hypometabolism in insulae and medial inferior frontal‐hypothalamus may be characteristic of patients with epilepsy and GAD‐ab. This PET pattern could be a useful diagnostic tool to identify GAD‐Ab patients.