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Neuroimaging in Epilepsy$
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Harry Chugani, MD

Print publication date: 2010

Print ISBN-13: 9780195342765

Published to Oxford Scholarship Online: January 2011

DOI: 10.1093/acprof:oso/9780195342765.001.0001

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Other PET Ligands Used in Epilepsy

Other PET Ligands Used in Epilepsy

(p.199) Chapter 13 Other PET Ligands Used in Epilepsy
Neuroimaging in Epilepsy

William H. Theodore

Oxford University Press

PET can be used to image neurotransmitter receptor ligands. Increased mu and delta, and probably decreased kappa opiate receptors have been demonstrated in patients with temporal lobe epilepsy (TLE). Ictal endogenous opiate release may occur in several seizure types. Increased MAO-B receptors in temporal lobe foci are consistent with focal gliosis. Reduced 5HT1A receptors have been found in TLE as well. The altered binding is correlated with depression, frequently associated with epilepsy, and may extend beyond the temporal lobe focus. Decreased dopamine receptor binding using a non-specific ligand was found in caudate and putamen in ring-chromosome 20 epilepsy and some patients with TLE. Reduced D2/D3 receptor binding was found in temporal lobe foci. Reduced NMDA receptor binding was reported in one TLE study. In autosomal dominant nocturnal frontal lobe epilepsy (ADNFLE), increased midbrain, pons and cerebellar, and decreased binding in dorsolateral prefrontal cortex nictotinic acetyl choline receptor binding was found. Patients with Rasmussen's encephalitis may have increased binding to the “peripheral benzodiazepine receptor,” also known as the “translocator protein 18 kilodalton.” The evidence in TLE is fragmentary. One study suggested increased p-glycoprotein transporter activity in TLE. Methodological problems include the fluctuating physiological state of patients with epilepsy, effects of antiepileptic drugs, and necessary partial volume correction for tissue loss in TLE and other anatomic lesions. However, PET has the potential to provide essential translational links between basic and clinical investigation of epilepsy.

Keywords:   receptors, opiates, dopamine, GABA, serotonin

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