Abstract Details

Title Glucose Metabolism of the Cerebellum in Temporal Lobe Epilepsy with Hippocampal Sclerosis

Topic Epilepsy/Clinical Neurophysiology (EEG)

Presentation(s) P3 - Poster Session 3 (5:00 PM-6:00 PM)

Poster/Presentation
Number 11-005

Objective To investigate the role of cerebellum in the epileptic network, the prevalence and clinical significance of crossed cerebellar diaschisis (CCD) in patients with hippocampal sclerosis (HS)-related temporal lobe epilepsy (TLE).

Background The cerebellum has been increasingly recognized as an important structure involved in epileptic networks. CCD is a phenomenon characterized by decreases in metabolism and perfusion in the cerebellar hemisphere contralateral to a unilateral supratentorial lesion. Although CCD has been extensively reported in various supratentorial disorders, the prevalence of CCD in TLE with HS remains unclear.

Design/Methods We retrospectively analyzed 95 adults with pathologically confirmed HS-related TLE. Preoperative FDG-PET images were normalized and quantified as standardized uptake value ratios (SUVr) using the whole grey matter as the reference. The cerebellum was parcellated into subregions of interest SUIT-cerebellum atlas. Bilateral cerebellar hemispheres and each pair of symmetric regions of interest (ROIs) were extracted to calculate an asymmetry index (AI). CCD was defined as positive when the absolute AI exceeded 0.1.

Results The cohort (35 men and 60 women) included 48 right-sided and 47 left-sided HS. Mean seizure onset age was 15.6 ± 10.2 years old and the average disease duration was 18.7 ± 11.9 years. Among 78 patients with ≥2 years of follow-up, 63(81%) achieved Engel class I. The mean absolute AI across cerebellar hemisphere was 0.0166 ± 0.0136 (range: 0.0003-0.0707). ROI-based analysis using the SUIT cerebellar atlas revealed generally low interhemispheric asymmetry across all subregions. The highest mean absolute AI values were found in lobule VIIb (0.0310 ± 0.0235), crus I (0.0376 ± 0.0292), and lobule IX (0.0331 ± 0.0251).

Conclusions In our cohort of HS-related TLE, no significant evidence of CCD was observed under FDG-PET–based asymmetry analysis. The absence of CCD in this cohort indicates that metabolic alterations in TLE are primarily confined to the epileptic network, without notable contralateral cerebellar involvement.

Authors/Disclosures
YU-CHI CHAO, MD PRESENTER	Dr. CHAO has nothing to disclose.
Chao Peng, PhD	The institution of Dr. Peng has received research support from NIH. The institution of Dr. Peng has received research support from MJFF.
Justin Chou, PhD	Dr. Chou has received personal compensation for serving as an employee of Kyverna Therapeutics. Dr. Chou has received intellectual property interests from a discovery or technology relating to health care.
Guoyun Yu, PhD	Dr. Yu has nothing to disclose.

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