Multilayer Metabolic Networks of Mesial Temporal Lobe Epilepsy: Insights from Simultaneous PET/MRSI

Motivation: How chronic epilepsy impacts the interplay between neuronal metabolites and inter-regional metabolic connectivity remains unclear. Goal(s): To identify neurometabolic imaging biomarkers for epilepsy progression using PET/MRSI. Approach: Forty-eight patients with drug-resistant mesial temporal lobe epilepsy and fifteen patients with extratemporal epilepsy underwent simultaneous high-resolution MRSI and FDG PET. Moderation effects of disease duration were evaluated for multiple brain regions; multilayer metabolic networks were constructed to investigate metabolic changes of NAA, FDG and their interplay. Results: We found disease duration moderated changes in the interplay between NAA and FDG. Metabolic networks form distinct modules in short duration and long duration groups. Impact: This is the first simultaneous PET/MRSI study to investigate multilayer metabolic network associated with disease duration of mTLE, which could offer a comprehensive view of neurometabolic profile, facilitating the exploration of imaging markers in epileptic lesion detection and disease progression.