Introduction - Animal experiments suggest that epileptic seizures alte
r the expression of mRNA for neuro-receptors. PET measurements with [C
-11]flumazenil show that patients with partial seizures have a reduced
density of benzodiazepine (BZ) receptors in the epileptogenic regions
(ER) and some of the target areas for seizure activity, the so called
projection areas. Recent data suggest that the degree of BZ receptor
reduction in ER is correlated to seizure frequency. We therefore hypot
hesized that seizure activity can alter the BZ receptor binding, and t
hat some of these changes could normalize when the seizures disappeare
d. Methods - In 4 patients whose seizures were generated by mesial tem
poral lobe structures, BZ receptor density was measured with [C-11]flu
mazenil PET before, and 1 year after the epilepsy surgery and cessatio
n of seizures. By use of a computerized anatomical brain atlas the sam
e regions were analyzed in both PET scans, and the results related to
data from 7 healthy controls. Results - Presurgical PET scans showed r
eductions in BZ receptor density in the epileptogenic region and some
of its primary projection areas. Other cortical regions had normal val
ues. Postsurgically, the calculated BZ receptor density normalized (29
+/-17% increase) in several of the affected projection areas, whereas
the values in other cortical regions remained unaltered. Conclusion -
Regional reductions in BZ receptor density may be dynamic and related
to seizures. The present preliminary observations encourage further st
udies on seizure-related changes in regional receptor binding in human
s.