Molecular Mechanisms Underlying NAA and FDG Uptake Coupling in Temporal Lobe Epilepsy: Insights from Imaging Transcriptomics

Motivation: The underlying mechanism between the coupling of neuronal marker N-acetyl aspartate (NAA) and glucose uptake in temporal lobe epilepsy (TLE) remains unclear. Goal(s): We aim to investigate molecular underpinnings of NAA and FDG correlations. Approach: Patients with drug resistant temporal lobe epilepsy underwent simultaneous high resolution whole-brain PET/MRSI. With processed NAA/Cr maps and FDG SUVR, we evaluated metabolic coupling across brain regions and identified cell types and pathways linked to these metabolic changes. Results: Our results revealed significant correlations between NAA and FDG in TLE-affected regions. Gene enrichment analysis further highlighted excitatory neuron involvement in TLE-related metabolic coupling. Impact: This study provides insight into the molecular basis of metabolic coupling in temporal lobe epilepsy, specifically examining the relationship between NAA levels and FDG uptake. The findings may shed new light on epileptogenesis and potential therapeutic targets.