Central benzodiazepine receptors in malformations of cortical development: A quantitative study

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  • Alexander Hammers, Hammersmith Hospital, National Society for Epilepsy
  • ,
  • Matthias J. Koepp, Hammersmith Hospital, National Society for Epilepsy
  • ,
  • Mark P. Richardson, Hammersmith Hospital, National Society for Epilepsy
  • ,
  • Claire Labbé, Hammersmith Hospital
  • ,
  • David J. Brooks
  • Vincent J. Cunningham, Hammersmith Hospital
  • ,
  • John S. Duncan, Hammersmith Hospital, National Society for Epilepsy

We calculated [11C]flumazenil volume of distribution ([11C]FMZ-Vd) after correction for partial volume effect in 10 patients with malformations of cortical development (MCDs) and partial seizures, to quantify the GABAA-central benzodiazepine receptor complex. Abnormal grey matter and adjacent or overlying cortex were outlined individually and added to an individualized anatomical template for correction for partial volume effect. Nine of 10 patients showed single or multiple increases or decreases in [11C]FMZ-Vd in or around MCDs. Two of three patients with band heterotopia showed multiple increases in the overlying cortex. In three of four patients with subependymal nodular heterotopia, nodules had lower [11C]FMZ-Vd than the overlying cortex, which was normal. Decreases in [11C]FMZ-Vd were found in two of three clefts and one of six adjacent regions in one schizencephalic patient; another had normal [11C]FMZ-Vd in the thickened cortex itself but increases in all adjacent regions. Binding was reduced within focal cortical dysplasia but increased in adjacent cortex. [11C]FMZ-Vd was normal within one patient's polymicrogyric cortex but increased in one of six adjacent volumes of interest. The localization of abnormalities correlated with EEG and clinical data in cortical MCDs. Flumazenil binding was decreased in some MCDs with increased grey matter volume and increased in some adjacent or overlying areas of normal-appearing cortex, suggesting functional abnormalities beyond MRI-detectable structural changes.

Original languageEnglish
JournalBrain
Volume124
Issue8
Pages (from-to)1555-1565
Number of pages11
ISSN0006-8950
Publication statusPublished - 20 Aug 2001
Externally publishedYes

    Research areas

  • Epilepsy, Flumazenil, Malformations of cortical development, PET

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