難治部分てんかん脳における中枢性ベンゾジアゼピン受容体の定量的解析 : ^<125>I-iomazenil autoradiography法による手術摘出標本の検索  [in Japanese] An Analytic Study of Central Benzodiazepine Receptor in the Surgically Resected Tissues of Patients with Intractable Localization-related Epilepsy : Quantitative Analysis using ^<125>I-iomazenil Autoradiography  [in Japanese]

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Abstract

中枢性ベンゾジアゼピン受容体 (以下、BZR) の特異的リガンドであるiomazenilを用いたautoradiographyとSPECTを行い難治局在関連てんかんにおけるBZRの変化を調べた。27例の外科切除標本の<SUP>125</SUP>I-iomazenil autoradiogramで、硬化所見に乏しい例の海馬ではBZRが全層に亘り保持されていたが、内側側頭葉硬化例の海馬ではCA1、3、4の神経細胞脱落の程度と相関したBZR濃度の低下を認めた。皮質形成異常例では形成異常の程度に比例してBZR濃度が低下していた。良性腫瘍と血管腫の症例では病変部のBZR濃度の低下が著明であった。<SUP>123</SUP>I-iomazenil SPECTが施行された9例中8例で焦点側の脳葉に低集積所見を認め、これに対応する切除標本のautoradiogramにおいてBZR濃度の低下が確認された。したがってautoradiogramによる定量的検索からてんかん原性焦点と密接に関連する領域におけるBZR濃度の変化が明らかとなり、SPECTの有用性を組織化学的に裏づける結果が得られた。

The authors report a quantitative autoradiographic analysis of benzodiazepine receptors using the partial inverse agonist <SUP>125</SUP>I-iomazenil in surgically resected tissues of 27 patients with intractable partial epilepsies. Pathological diagnosis of these tissues was; 14 mesial temporal sclerosis (MTS), 8 dysembryoplastic neuroepithelial tumor (DNT), 4 cortical dysplasia (CD) and 1 angioma. In MTS patients, the density of benzodiazepine receptors decreased in CAl, CA3 and CA4. The layers of gyrus dentatus were displaced with a thick and high density band. These findings were similar to simultaneous GABA-A stain findings. The decrease of receptor in each hippocampal structure highly correlated to the degree of cell loss in CAl, CA3 and CA4. The receptors were almost absent in the main lesions of DNT and angioma, and showed irregular distributions in the cortex around these lesions. The receptor den-sities of CD were parallel to Palmini's pathological grading. Nine cases were analyzed using <SUP>123</SUP>I-iomazenil SPECT before surgery after obtaining informed consent. Eight of them revealed marked low accumulations in the areas corresponding to the epile-ptogenic foci. We conclude that our results support histochemically the clinical availa-bility of <SUP>123</SUP>I-iomazenil SPECT as a non-invasive technique for detecting the changes in benzodiazepine receptor densities in patients with partial epilepsies.

Journal

  • Journal of the Japan Epilepsy Society

    Journal of the Japan Epilepsy Society 16(2), 117-126, 1998-06-30

    JAPAN EPILEPSY SOCIETY

References:  12

Cited by:  1

Codes

  • NII Article ID (NAID)
    10008555996
  • NII NACSIS-CAT ID (NCID)
    AN10043823
  • Text Lang
    JPN
  • Article Type
    Journal Article
  • ISSN
    09120890
  • Data Source
    CJP  CJPref  J-STAGE 
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