Positron Emission Tomography with [¹¹C]Deuterium‐Deprenyl in Temporal Lobe Epilepsy

Abstract

We performed positron emission tomography (PET) with [11C]deuterium-deprenyl in 9 patients with temporal lobe epilepsy (TLE) undergoing evaluation for possible epilepsy surgery. Seven patients had unilateral and 2 had bilateral mesiotemporal epileptic foci based on the preoperative investigation including ictal EEG discharges and PET with 2-[18F]fluoro-2-deoxyglucose (FDG). Deprenyl is an irreversible inhibitor of monoamine oxidase type B (MAO-B) with a very high affinity for the enzyme. In the brain, MAO-B is preferentially located in astrocytes, and a previous in vitro study showed increased binding of the ligand in sclerotic hippocampi. Dynamically acquired N-[methyl-11C]-a,a-di-deutero-L-deprenyl distribution in PET images were analyzed graphically, and the focus regions were assessed visually on the PET images. In addition, the accumulation rate and distribution volume of the tracer relative to the cerebellar cortex were measured in standardized homologous temporal regions by semiquantitative methods. Uptake of [11C]deuterium-deprenyl was significantly increased in the epileptogenic temporal lobes, both apparently and semiquantitatively. By calculating mean interlobar ratios, we identified the temporal lobe containing the epileptic focus in six unilateral cases. One case was ambiguous but was not falsely localized. The two bilateral cases were correctly identified as such. Our results suggest that PET with [11C]deuterium-deprenyl might be a useful method for identification of epileptogenic temporal lobes.

Astroglial Responses to Amyloid-Beta Progression in a Mouse Model of Alzheimer’s Disease

“…The PET radioligand [ 11 C]DED was synthesized as previously described [35]. Four groups of animals were investigated; 8-month-old APP ArcSwe (n = 5), 8-month-old WT (n = 5), 16-month-old APP ArcSwe (n = 4), and 16-month-old WT (n = 6).…”

Presurgical evaluation and surgical treatment of medically refractory epilepsy

“…18 F] fluorodeoxyglucose and [ 11 C] flumazenil [82,110,233,234]. In temporal lobe epilepsy, interictal PET demonstrates hypometabolism in about 60-90% of patients and therefore can be used in presurgical diagnosis [82].…”

Positron Emission Tomography Receptor Studies

“…In 9 patients with temporal lobe epilepsy, uptake of "C-deuterium deprenyl was increased in the epileptogenic temporal lobe, possibly reflecting gliosis (27). This technique does not appear to be likely to contribute to precise localization of an epileptic focus within the temporal lobe, but the anatomical discrimination of medial temporal lobe structures was rather limited.…”