Expression of fructose-1,6-bisphosphatase 1 is associated with [F-18]FDG uptake and prognosis in patients with mesial temporal lobe epilepsy

ObjectivesTo determine whether fructose-1,6-bisphosphatase 1 (FBP1) expression is associated with [F-18]FDG PET uptake and postsurgical outcomes in patients with mesial temporal lobe epilepsy (mTLE) and to investigate whether the molecular mechanism involving gamma-aminobutyric acid type A receptor (GABA(A)R), glucose transporter-3 (GLUT-3), and hexokinase-II (HK-II).MethodsForty-three patients with mTLE underwent [F-18]FDG PET/CT. Patients were divided into Ia (Engel class Ia) and non-Ia (Engel class Ib-IV) groups according to more than 1 year of follow-up after surgery. The maximum standard uptake value (SUVmax) and asymmetry index (AI) of hippocampus were measured. The relationship among the SUVmax, AI, prognosis, and FBP1 expression was analyzed. A lithium-pilocarpine acute mTLE rat model was subjected to [F-18]FDG micro-PET/CT. Hippocampal SUVmax and FBP1, GABA(A)R, GLUT-3, and HK-II expression were analyzed.ResultsSUV(max) was higher in the Ia group than in the non-Ia group (7.31 +/- 0.97 vs. 6.56 +/- 0.96, p < 0.05) and FBP1 expression was lower in the Ia group (0.24 +/- 0.03 vs. 0.27 +/- 0.03, p < 0.01). FBP1 expression was negatively associated with SUVmax and AI (p < 0.01). In mTLE rats, the hippocampal FBP1 increased (0.26 +/- 0.00 vs. 0.17 +/- 0.00, p < 0.0001), and SUVmax, GLUT-3 and GABA(A)R levels decreased significantly (0.73 +/- 0.12 vs. 1.46 +/- 0.23, 0.20 +/- 0.01 vs. 0.32 +/- 0.05, 0.26 +/- 0.02 vs. 0.35 +/- 0.02, p < 0.05); no significant difference in HK-II levels was observed. In mTLE patients and rats, FBP1 negatively correlated with SUVmax and GLUT-3 and GABA(A)R levels (p < 0.05).ConclusionFBP1 expression was inversely associated with SUVmax in mTLE, which might inhibit [F-18]FDG uptake by regulating GLUT-3 expression. High FBP1 expression was indicative of low GABA(A)R expression and poor prognosis.