Metabolic network is related to surgical outcome in temporal lobe epilepsy with hippocampal sclerosis: A brain FDG‐PET study.

Background and Purpose: The aim of this study was to investigate differences in metabolic networks based on preoperative fluorodeoxyglucose (FDG)‐positron emission tomography (PET) in temporal lobe epilepsy (TLE) with hippocampal sclerosis (HS) between patients with complete seizure‐free (SF) and those with noncomplete seizure‐free (non‐SF) after anterior temporal lobectomy. Methods: This study was retrospectively performed at a tertiary hospital. We recruited pathologically confirmed 75 TLE patients with HS who underwent preoperative FDG‐PET. All patients underwent a standard anterior temporal lobectomy. The surgical outcome was evaluated at least 12 months after surgery, and we divided the subjects into patients with SF (International League Against Epilepsy [ILAE] class I) and those with non‐SF (ILAE class II‐VI). We evaluated the metabolic network using graph theoretical analysis based on FDG‐PET. We investigated the differences in network measures between the two groups. Results: Of the 75 TLE patients with HS, 32 patients (42.6%) had SF, whereas 43 patients (57.3%) had non‐SF. There were significant differences in global metabolic networks according to surgical outcomes. The patients with SF had a lower assortative coefficient than those with non‐SF (–0.020 vs. –0.009, p =.044). We also found widespread regional differences in local metabolic networks according to surgical outcomes. Conclusion: Our study demonstrates significant differences in preoperative metabolic networks based on FDG‐PET in TLE patients with HS according to surgical outcomes. This work introduces a metabolic network based on FDG‐PET and can be used as a potential tool for predicting surgical outcome in TLE patients with HS. [ABSTRACT FROM AUTHOR]