-
[show abstract]
[hide abstract]
ABSTRACT: BACKGROUND: Various techniques used to assess brain iron concentrations have demonstrated the presence of low iron stores in patients with restless legs syndrome (RLS). Previous open-label and randomized studies generally support the value of iron treatment for RLS symptoms. Only one of these studies assessed iron therapy response to changes in brain iron status. The current study was designed to assess the effect of iron therapy on RLS symptoms and on CSF measures of brain iron status. METHODS: Idiopathic RLS patients drawn from the Korean population received four weekly intravenous (IV) doses of 250mg low-molecular weight iron dextran for a total dose of 1g. One week after the last dose, any subject on RLS medication tapered off the RLS medications. Blood and CSF samples were taken to measure iron parameters at baseline and again, three weeks after the last dose. We have been following their response to the drug for two years after treatment. RESULTS: Twenty-five patients (age 55.2±9.3, 18 female) enrolled in this study without serious adverse reactions. Seventeen of the 25 patients (68%) showed moderate or complete improvement of all RLS symptoms after treatment based on the Korean-translated versions of the International RLS Severity scale (K-IRLS). Changes in the K-IRLS did not correlate significantly with changes in CSF ferritin. The response to IV iron could not be predicted by patients' demographics, or by blood or CSF iron baseline characteristics. RLS symptom improvement started between one and six weeks after treatment and the treatment benefits lasted from one month to 22months. Fourteen patients, (56%) completely stopped all medications, for a mean duration of 31.3±33.1weeks. These results are comparable to those from a prior study with high molecular weight dextran. CONCLUSIONS: Intravenous low-molecular weight iron dextran produced significant improvement of RLS symptoms in a majority of patients without any significant adverse effects. Serious anaphylaxis occurs with high molecular weight, but rarely, if ever, with this low molecular weight dextran. Given apparent comparable efficacy the low molecular weight and not the high molecular weight iron dextran, should be considered for RLS treatment. Although changes in CSF ferritin were seen following therapy, these changes were not related to clinical improvements.
Sleep Medicine 01/2013; · 3.40 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Dopamine agonists are first-line drugs for treating the symptoms of restless legs syndrome (RLS). However, few studies have investigated the effect of dopamine agonists on the quality of life (QoL) in RLS patients. We conducted a study to determine whether ropinirole exerts positive effects on the QoL in RLS patients and to analyze the underlying factors.
Primary RLS patients from eight medical centers were recruited in the study. They were evaluated in the baseline phase using various questionnaires including the Korean versions of the International Restless Legs Scale (K-IRLS), RLS QoL questionnaire (K-RLSQoL), and the Short Form 36 Health Survey (SF-36). After taking ropinirole for 8 weeks the same questionnaires were again completed as a re-evaluation. We analyzed the statistical difference using a paired t-test, a Pearson's correlation, and a stepwise multiple regression in order to identify the factors associated with the QoL change.
A total of 107 subjects, including 65 (60.7%) females, completed this study. They were aged 51.68±14.80 years (mean±SD) and had a symptom duration of 8.8±9.0 months. After treatment with ropinirole, there were significant improvements on the K-RLSQoL, SF-36, and K-IRLS. The Pearson's correlation analysis showed that the improvement of QoL in RLS patients was significantly correlated with the severity of RLS (r=0.236, p<0.014) at baseline.
The results from this study suggest that treatment with ropinirole can improve the QoL in RLS patients. The improvement in the QoL is more related with the improvement of RLS symptoms.
Journal of Clinical Neurology 01/2013; 9(1):51-6. · 1.69 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Restless Legs Syndrome/Willis-Ekbom Disease (RLS/WED) is a sensorimotor disorder that causes patients to experience overwhelming and distressing sensations in the legs compelling the patient to move their legs to provide relief. The purpose of this study was to determine if biomarkers in the cerebrospinal fluid can distinguish RLS/WED patients from neurological controls.
We obtained CSF samples by lumbar puncture from 5 early-onset RLS/WED patients and 5 controls. We performed 2-dimensional difference in-gel electrophoresis (2D-DIGE). Proteins that were significantly altered were identified by Student's t-test. Protein spots that were differentially expressed (p ≤ 0.05, Av. Ratio ≥ 2.0) between RLS/WED and control CSF samples were identified using MALDI-TOF-MS. Statistical analyses of the validation immunoblot assays were performed using Student's t-test.
In this discovery study we identified 6 candidate CSF protein markers for early-onset RLS/WED. Four proteins (Cystatin C, Lipocalin-type Prostaglandin D2 Synthase, Vitamin D binding Protein, and β-Hemoglobin) were increased and 2 proteins (Apolipoprotein A1 and α-1-acid Glycoprotein) were decreased in RLS/WED patients.
Our results reveal a protein profile in the RLS/WED CSF that is consistent with clinical findings of disruptive sleep, cardiovascular dysfunction and painful symptoms. Moreover, protein profiles are consistent with neuropathological findings of activation of hypoxia inducible factor (HIF) pathways and alterations in dopaminergic systems. These data indicate the CSF of RLS/WED patients may provide information relevant to biological basis for RLS/WED, treatment strategies and potential new treatment targets.
Fluids and barriers of the CNS. 01/2013; 10(1):20.
-
[show abstract]
[hide abstract]
ABSTRACT: PURPOSE: To investigate clinical characteristics associated with wicket spikes in patients undergoing long-term video-EEG monitoring. METHODS: A case-control study was performed in 479 patients undergoing video-EEG monitoring, with 3 age- (±3 years) and gender-matched controls per patient with wicket spikes. Logistic regression was utilized to investigate the association between wicket spikes and other factors, including conditions that have been previously associated with wicket spikes. RESULTS: Wicket spikes were recorded in 48 patients. There was a significantly higher prevalence of dizziness/vertigo (p=0.002), headaches (p=0.005), migraine (p=0.015), and seizures (p=0.016) in patients with wickets. The majority of patients with wicket spikes did not exhibit epileptiform activity on EEG; however, patients with history of seizures were more likely to have wickets (p=0.017). There was no significant difference in the prevalence of psychogenic non-epileptic seizures between the groups. Wickets were more common on the left, during sleep, and more likely to be first recorded on day 1-2 of monitoring. CONCLUSIONS: Patients with wicket spikes are more likely to have dizziness/vertigo, headaches, migraine, and seizures. Patients with history of seizures are more likely to have wickets. The prevalence of psychogenic non-epileptic seizures is not significantly higher in patients with wickets.
Seizure 10/2012; · 1.80 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: We studied characteristics of epilepsy patients who use 'Epilia', a healthcare website for epilepsy patients, and the impact of 'Epilia' on patient satisfaction and attitude about epilepsy. A total of 153 epilepsy patients from 'Epilia' (online group) and 367 patients from epilepsy clinics (offline group) were recruited. A survey was done to investigate their socio-demographic, epilepsy-related, and psychological characteristics, as well as attitude alterations after beginning to use 'Epilia'. Factors affecting attitude were also identified in the online group. Online group had more severe and more frequent seizures, more adverse effects, more anxiety and depression, and worse quality of life than offline group. Online group patients who are more satisfied, who take two or more antiepileptic drugs, who visit to 'Epilia' more and longer had a greater positive attitude change than those without these characteristics. A healthcare website can contribute to self-management by providing useful information and education for epilepsy patients.
Epilepsy & Behavior 09/2012; 25(2):156-61. · 2.34 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: There have been few quality of life (QoL) studies of patients with restless legs syndrome (RLS) in Asian countries. We studied the QoL of patients with RLS and compared it to normal controls and patients with hypertension, type 2 diabetes, or osteoarthritis in Korea.
A total of 215 RLS patients (141 female; mean age 51.7±13.5) were enrolled. All patients completed the questionnaires, including all the Korean versions of SF-36, RLS QoL, the International RLS Severity scale (IRLS), the Pittsburgh Sleep Quality Index (PSQI), and the Beck Depression Inventory-2 (BDI-2). These results were compared with the scores from normal controls (N=214) and from patients with hypertension (196), uncomplicated type 2 diabetes (185), or osteoarthritis of the knee (177).
The SF-36 QoL in patients with RLS was lower than that of the normal controls, and even lower than patients with hypertension or diabetes, but higher than those with osteoarthritis. The SF-36 Qol of RLS patients showed a significantly negative correlation with the severity of RLS symptoms(r=-0.430, p<0.001) and the severity of depression (r=-0.565, p<0.001), but was not significantly related to gender, age, or age-of-symptom onset (early or late-onset). Step-wise multiple regression identified three factors related to SF-36 QoL: depression (46.5% of RLS had responses on BDI-2 indicating depression) (β=-.899, p<0.001), RLS symptom severity (K-IRLS) (β=-.718, p<0.001), and gender (female) (β=-6.128, p=0.007).
These findings show that RLS has a considerable impact on the QoL of Koreans, which is comparable with studies of western countries. The QoL impairment relates to the degree of depression with RLS for Koreans.
Sleep Medicine 08/2012; 13(9):1158-63. · 3.40 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: The Korean national health security system covers the entire population and all medical facilities. We aimed to estimate epilepsy prevalence, anticonvulsant utilization pattern and the cost. We identified prevalent epilepsy patients by the prescription of anticonvulsants under the diagnostic codes suggesting seizure or epilepsy from 2007 Korean National Health Insurance databases. The information of demography, residential area, the kind of medical security service reflecting economic status, anticonvulsants, and the costs was extracted. The overall prevalence of treated epilepsy patients was 2.41/1,000, and higher for men than women. The age-specific prevalence was the lowest in those in their thirties and forties. Epilepsy was more prevalent among lower-income individuals receiving medical aid. The regional prevalence was the highest in Jeju Island and lowest in Ulsan city. New anticonvulsants were more frequently used than old anticonvulsants in the younger age group. The total annual cost of epilepsy or seizure reached 0.46% of total medical expenditure and 0.27% of total expenditure on health. This is the first nationwide epidemiological report issued on epilepsy in Korea. Epilepsy prevalence in Korea is comparable to those in developed countries. Economic status and geography affect the prevalence of epilepsy.
Journal of Korean medical science 03/2012; 27(3):285-90. · 0.84 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Older adults perform much like younger adults on language. This similar level of performance, however, may come about through different underlying brain processes. In the present study, we evaluated age-related differences in the brain areas outside the typical language areas among adults using a category decision task. Our results showed that similar activation patterns were found in classical language processing areas across the three age groups although regional lateralization indices in Broca's and Wernicke's areas decreased with age. The greatest differences, however, among the three groups were found primarily in the brain areas not associated with core language functioning including the hippocampus, middle frontal gyrus, ventromedial frontal cortex, medial superior parietal cortex and posterior cingulate cortex. Therefore, the non-classical language areas may exhibit an age-related difference between three age groups while the subjects show a similar activation pattern in the core, primary language processing during a semantic decision task.
Brain and Language 02/2012; 120(3):372-80. · 3.12 Impact Factor
-
Archives of neurology 02/2012; 69(2):272-3. · 6.31 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: The Pittsburgh Sleep Quality Index (PSQI) is a self-reported questionnaire that measures sleep quality during the previous month. The aims of this study were to analyze the reliability and validity of the Korean version of the PSQI (PSQI-K) and to evaluate its usefulness.
We developed the PSQI-K, which involved translating the original PSQI into Korean and then translating back into English to check its accuracy. We tested the validity of the PSQI-K on a total of 394 individuals: 261 with poor sleep (primary insomnia, n = 211; narcolepsy, n = 50) and 133 with good sleep. All subjects completed the PSQI-K, 285 had overnight nocturnal polysomnography, and 53 were randomly selected for a retest with the questionnaire after 2-4 weeks without any intervening treatment. The mean PSQI-K global scores in each group were analyzed after adjusting for age and sex.
Cronbach's α coefficient for internal consistency of the total score of the PSQI-K was 0.84 which shows high reliability. Sensitivity and specificity for distinguishing poor and good sleepers were 0.943 and 0.844 using the best cutoff point of 8.5. The total and component scores of the PSQI-K for insomnia and narcolepsy were significantly higher than those for controls (p < 0.05). The test-retest correlation coefficient was 0.65 for the total score (p < 0.001). There was no significant difference between the two values using the paired t tests.
The PSQI-K is a reliable and valid questionnaire for evaluating sleep quality in patients with sleep disorders.
Sleep And Breathing 09/2011; 16(3):803-12. · 1.84 Impact Factor
-
Dong-Uk Kim,
Myeong-Kyu Kim, Yong-Won Cho,
Yo-Sik Kim,
Won-Joo Kim,
Min Goo Lee,
Sung Eun Kim,
Tai-Seung Nam,
Ki-Hyun Cho,
Young-Ok Kim,
Min-Cheol Lee
[show abstract]
[hide abstract]
ABSTRACT: It would be likely that the genetic variants of the GTA3 gene encoding GAT-3, an astrocytic GABA transporter, may alter gamma-aminobutyric acid (GABA) neurotransmission in the synaptic cleft in the epileptic brain and cause antiepileptic drugs (AEDs) pharmacoresistance. A candidate gene association analysis with fine mapping was performed to dissect the genetic contributions of GAT3 to AEDs pharmacoresistance. Two independent case sample sets were recruited (Samples 1 and 2), and each set was divided into two groups (drug-resistant and drug-responsive) according to the treatment outcomes with AEDs. Sample1 (n=400) was used for the initial exploratory stage of the study and sample 2 (n=435) was used for confirmation of the genetic association in the replication stage of the study. A GAT3 polymorphism (GAT3 c.1572 C>T, rs2272400) was nominally associated with AEDs pharmacoresistance (P(CC) vs P(CT/TT)=0.012, P(allelic)=0.01). The odds ratio (OR) for AED pharmacoresistance was 1.6 (95% confidence interval (CI), 1.11-2.24; P=0.01) in the additive models of inheritance. The statistical significance remained after we adjusted for a confounding factor, the etiology of epilepsy, at 0.012 (adjusted OR: 1.73, 95% CI: 1.13-2.67) and used Bonferroni's correction for multiple comparisons at 0.048. Importantly, the positive association of c.1572 T was reproduced in the replication stage (P(allelic)=0.037, joint P-value of the replication=0.001). The results suggest that GAT3 c.1572T may be one of the contributing factors with a modest effect on AEDs pharmacoresistance in the epileptic brain, shed light on a better understanding of the underlying mechanisms and serve as an impetus for new avenues of treatment for AEDs pharmacoresistance.
Journal of Human Genetics 07/2011; 56(9):640-6. · 2.57 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: There is relatively little known about the effects of new antiepileptic drugs (AEDs) on sleep. This study was done to evaluate the effect of levetiracetam (LEV) on subjective sleep quality and sleep architecture in patients with epilepsy, and the results were compared with the effects of carbamazepine-CR (CBZ-CR).
This is a longitudinal randomized controlled trial using two different treatments, LEV (1000 mg/day) or CBZ-CR (400mg/day). Thirty-one subjects (16 LEV and 15 CBZ-CR) had partial epilepsy and were tested with an overnight polysomnography (PSG) with full 10-20 electrodes. Sleep questionnaires and National Hospital Seizure severity Scale (NHS3) were evaluated. PSG and the questionnaires were repeated after 4-6 weeks of treatment.
In the LEV group, when treatment PSG findings were compared with baseline, there was a significant increase in sleep efficiency (p=0.039) but no changes in subjective sleep parameters. In the CBZ-CR group, there was a significant increase in the percentage of slow wave sleep (p=0.038) while other sleep parameters were not significantly changed after treatment. There were no significant differences in effects on sleep between the LEV and CBZ-CR groups.
LEV may increase sleep efficiency without major effects on sleep structure with an overall effect on sleep parameters comparable to CBZ-CR.
Seizure 02/2011; 20(4):336-9. · 1.80 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: To investigate the epistatic interactions involved in antiepileptic drug (AED) resistance, 26 coding single-nucleotide polymorphisms (SNPs) were selected from 16 candidate genes. A total of 200 patients with drug-resistant localization-related epilepsy and 200 patients with drug-responsive localization-related epilepsy were genotyped individually for the SNPs. Rather than using the traditional parametric statistical method, a new statistical method, multifactor dimensionality reduction (MDR), was used to determine whether gene-gene interactions increase the risk of AED resistance. The MDR method indicated that a combination of four SNPs (rs12658835 and rs35166395 from GABRA1, rs2228622 from EAAT3 and rs2304725 from GAT3) was the best model for predicting susceptibility to AED resistance with a statistically significant testing accuracy of 0.625 (P < 0.001) and cross-validation consistency of 10/10. This best model had an odds ratio of 3.68 with a significant 95% confidence interval of 2.32-5.85 (P < 0.0001). Our results may provide meaningful information on the mechanism underlying AED resistance and, to the best of our knowledge, this is the first report of evidence for gene-gene interactions underlying AED resistance.
Journal of Human Genetics 01/2011; 56(1):71-6. · 2.57 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: A multicentre face-to-face interview was conducted to identify factors contributing to the marital status of people with epilepsy (PWE) in Korea. The marriage rate of PWEs was only 80% and the divorce rate was more than double that in the general population. Among the single subjects, 34% replied that they were unmarried because of epilepsy, and 76% of divorced PWEs replied that epilepsy was the cause of the divorce. The factors affecting the single and divorced status in PWEs included gender, an earlier onset of seizure and seizure onset before marriage. Not informing the spouse of the disease before marriage for fear of discrimination was not related to disadvantage in marriage negotiation or to divorce. Social stigmatization of epilepsy continues and impacts on the marital status of PWEs in Korea. However, there is no correlation between the perceived and the enacted stigmas of epilepsy.
Seizure 09/2010; 19(9):573-9. · 1.80 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: The Epworth sleepiness scale (ESS) is widely used to measure the subject's average sleep propensity across those different situations in daily life, particularly in patients with sleep-disordered breathing. The purposes of this study were to test the hypothesis that the Korean version of the ESS (KESS) is valid and evaluate its usefulness.
We developed the KESS, which involved translating into Korean and then translating back into English to check its accuracy. A total of 273 participants (181 obstructive sleep apnea (OSA)-37 mild, 61 moderate, 83 severe, 32 simple snoring and 60 normal) were included in this study. All subjects completed the overnight polysomnograph and 53 of the total subjects were randomly selected for a retest with the questionnaire approximately 2∼4 weeks later. The associations between KESS and the degree of OSA were examined through ANCOVA, adjusted for age, sex and BMI.
The total score and each item's score of KESS in patients with OSA were significantly higher than subjects with normal controls (p < 0.01). As the severity of OSA increased, the KESS showed significantly increasing patterns (p for trend <0.01). The KESS in patient groups showed good internal consistency (Cronbach's α = 0.90) and test-retest reliability (r = 0.78 to 0.93).
The KESS is a reliable and valid tool for screening patients with daytime sleepiness in Korea.
Sleep And Breathing 04/2010; 15(3):377-84. · 1.84 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: We describe a patient with seizures arising from right anterior-inferior frontal lobe presenting as myoclonic epilepsy. A 19-year-old man had experienced frequent paroxysmal bilateral myoclonic jerks involving his upper arms, shoulders, neck, and upper trunk since the age of 10. His baseline EEG showed intermittent right frontal spikes, and his ictal EEG showed rhythmic sharp theta discharges in the same area. MRI revealed cortical dysplasia in the right inferior frontal gyrus, and ictal-interictal SPECT analysis by SPM showed increased signal abnormality in this region. Diffusion tensor imaging (DTI) showed defects in fasciculi in the same area. These findings suggest that frontal lobe epilepsy should be considered in some patients with myoclonic seizures.
Epilepsy & Behavior 02/2010; 17(4):561-4. · 2.34 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: This study identifies differences between people with epilepsy (PWE) and healthy controls in South Korea with respect to their familiarity with, understanding of, and attitudes toward epilepsy. PWE and controls older than 18 years of age were recruited from outpatient clinics and health promotion centers, respectively, associated with five university hospitals located throughout the country. Structured questionnaires consisting of 18 items were administered in face-to-face interviews. The sample consisted of 1924 participants (PWE: 384, controls: 1540). The groups did not differ with respect to age, sex, and place of residence. However, the groups did differ significantly in educational, marital, and occupational status (P=0.000). Familiarity with seizures and epilepsy (two items) did not differ significantly between the groups. Questions pertaining to understanding seizures and epilepsy (seven items) showed that controls had significantly greater misunderstanding of the etiology and long-term prognosis of epilepsy compared with PWE. Attitudes expressed toward PWE were significantly different in response to six of seven questions. Control subjects expressed more negative attitudes toward PWE than did PWE themselves, particularly concerning potential relationships with their children (e.g., friendships, marriage). In conclusion, we found significant differences between PWE and controls, particularly with respect to understanding of and attitudes toward epilepsy. We recommend the development of different strategies for PWE and controls to improve understanding of and attitudes toward epilepsy and to reduce the knowledge gap between these groups. Nationwide educational programs conducted by associated organizations and the government may provide the solution to this problem.
Epilepsy & Behavior 09/2009; 16(2):260-7. · 2.34 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: The incidence of atypical handedness (left-handedness and ambidexterity) in patients with epilepsy, particularly its association with major clinical factors, is not well established. We evaluated a full range of clinical variables in 478 patients with epilepsy from the United States and Korea. With the Edinburgh Handedness Inventory, handedness was established as both a categorical variable (right-handed, left-handed, ambidextrous) and a continuous variable. Seizures were classified as complex or simple partial, primary generalized, or generalized tonic-clonic. The relationship between handedness and a range of clinical findings was explored. The overall incidence of atypical handedness in our patients was higher than in the general population (13.6%) and significantly higher in the U.S. patient group (17.6%) than in the Korean patients (8.8%). Handedness was not associated with sex; age; seizure type; age at onset; type, side, or site of EEG or brain imaging abnormalities; family history of seizures; refractory epilepsy; or history of epilepsy surgery.
Epilepsy & Behavior 09/2009; 16(2):330-4. · 2.34 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Insomnia is a common complaint in adults. However, large epidemiologic studies of insomnia involving Asian populations are rarely reported. We performed an epidemiologic study of insomnia in a large Korean adult population.
A total of 5,000 subjects (2,470 men and 2,530 women) were interviewed by telephone. A representative sample of subjects aged 20 to 69 years was constituted according to a stratified, multistage random sampling method. Insomnia was defined as either any difficulty getting to sleep or getting back to sleep after waking in the night.
More than one fifth (n=1,141, 22.8%) of the 5,000 subjects complained of insomnia, with the prevalence being significantly higher in women (25.3%) than in men (20.2%, p<0.001). Logistic regression revealed that the prevalence of insomnia increased significantly with age (p<0.001), being higher in those aged 60-69 years than in those aged 20-29 years (OR=2.368, 95% CI=1.762-3.182, p<0.001), and was lower in those with a monthly income of >4.5 million Korean won than in those with an income of <1.5 million Korean won (OR=0.689, 95% CI=0.523-0.906, p<0.01).
Insomnia is a common complaint in Korean adults, and its prevalence is similar to that in adults in Western countries.
Journal of Clinical Neurology 03/2009; 5(1):20-3. · 1.69 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Arterial spin labeling (ASL) is a developing magnetic resonance imaging (MRI) method for noninvasive measurement of cerebral blood flow (CBF). The purpose of this study was to evaluate the usefulness of ASL for detecting interictal temporal hypoperfusion in temporal lobe epilepsy (TLE). ASL-derived CBF measurements were compared with those derived from H(2)(15)O positron emission tomography (PET).
11 normal controls and 10 patients with medically intractable TLE were studied. Pulsed ASL (PASL) with quantitative imaging of perfusion using a single subtraction, second version (QUIPSS II) was performed in all subjects and H(2)(15)O PET was performed in patients. Regional CBF values in the mesial and lateral temporal lobes were measured utilizing quantitative analysis of perfusion images. A perfusion asymmetry index (AI) was calculated for each region.
In patients, mean CBF in the mesial temporal lobe was not significantly different between PASL and H(2)(15)O PET, and ipsilateral mesial temporal CBF was lower than contralateral CBF with both techniques. PASL detected significant mesial temporal perfusion asymmetry agreeing with EEG laterality in four patients. H(2)(15)O PET found ipsilateral interictal hypoperfusion in three. Both scans found unilateral hypoperfusion in one patient with bilateral EEG discharges.
Pulsed ASL may be a promising approach to detecting interictal hypoperfusion in TLE. This method has potential as a clinical alternative to H(2)(15)O PET due to noninvasiveness and easy accessibility.
Epilepsy research 01/2009; 82(2-3):183-9. · 2.48 Impact Factor
