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Klinische Neurophysiologie 2002; 33(3): 147-155
DOI: 10.1055/s-2002-34827
Originalia
© Georg Thieme Verlag Stuttgart · New York

Präoperative Untersuchung in der Epilepsiechirurgie: GABA- und Adenosinrezeptoren bei pharmakoresistenter, fokaler Temporallappenepilepsie mit Positronenemissionstomographie (PET)

Preoperative Studies in Epilepsy Surgery: Analysis of GABA and Adenosine Receptors in Pharmacoresistant Focal Temporal Epilepsy Via Positron Emission Tomography (PET)C.  Boy1 , M.  Holschbach2 , H.  Herzog1 , A.  Bauer1 , H.  H.  Coenen2 , K.  Zilles1, 3
  • 1Institut für Medizin
  • 2Institut für Nuklearchemie, Forschungszentrum Jülich
  • 3Institut für Hirnforschung, Universität Düsseldorf
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Publication History

Publication Date:
17 October 2002 (online)

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Zusammenfassung

Die Rolle von GABA- und Adenosinrezeptoren für die Pathophysiologie der Epilepsie wird in der Literatur betont, es liegen aber vor allem für die Adenosinrezeptoren widersprüchliche Ergebnisse aufgrund von tierexperimentellen und In-vitro-Studien an menschlichem Hirngewebe vor. Ziel unseres Projektes ist es daher, durch präoperative Untersuchungen der Benzodiazepinbindungsstellen am GABAA-Rezeptor und des Adenosin-A1-Rezeptors mit der Positronenemissionstomographie (PET) an gesunden Probanden und Patienten mit pharmakoresistenter, fokaler temporaler Epilepsie die Rolle der Rezeptoren zu analysieren. Dieser Schritt wird durch postoperative Untersuchungen der Rezeptoren mit hochauflösender, quantitativer In-vitro-Rezeptorautoradiographie an neurochirurgisch gewonnenem Hirngewebe derselben Patienten ergänzt (s. Bidmon et al., dieses Heft). Das von uns begonnene Programm kann durch ein neuartiges interiktales Messverfahren zur prächirurgischen Epilepsiediagnostik beitragen: Mittels PET werden innerhalb von 5 Stunden der zerebrale Blutfluss, die regionale Verteilung der GABAA-Benzodiazepin (BZ)-Bindungsstellen und weltweit erstmalig auch der Adenosin-A1-Rezeptoren gemessen. Die jetzt vorliegenden ersten Untersuchungen an Probanden zeigen eine Verteilung der BZ-Bindungsstellen und Adenosin-A1-Rezeptoren, die weitgehend mit der aus In-vitro-Untersuchungen bekannten regionalen Verteilung dieser Rezeptoren übereinstimmt. Messungen an einer größeren Gruppe von Patienten werden begonnen.

Abstract

The role of GABA and adenosine receptors in the pathophysiology of epilepsy has been described, but particularly the role of adenosine receptors is controversely discussed in publications of animal experiments and in vitro studies of human brain tissue. The aim of our project is an analysis of the role of these receptors by presurgical studies using positron emission tomography (PET) in healthy volunteers and patients suffering from pharmacoresistant focal temporal epilepsy. This step will be supplemented by postoperative measurements of the receptors using high-resolution, quantitative in vitro receptor autoradiography of neurosurgically removed brain tissue from the same patients (see Bidmon et al., this volume). Our recently initiated programme using interictal measurements will contribute to the presurgical diagnostics of epilepsy: within five hours, the cerebral blood flow, and the regional distributions of benzodiazepine (BZ) binding sites of the GABAA receptor as well as for the first time that of adenosine A1-receptors are determined. The first measurements of healthy volunteers show a distribution pattern of both receptors which fits the pattern known from our own in vitro studies. Measurements of a larger group of patients are in progress.

Key words

Epilepsy - human - adenosine receptors - GABAA receptors - functional imaging - positron emission tomography

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Prof. Dr. Karl Zilles

Institut für Medizin-Forschungszentrum Jülich

52425 Jülich

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