Effects of an intravaginal GnRH analogue administration on rabbit reproductive parameters and welfare.

On commercial farms, rabbit does are subjected to a reproductive rhythm that does not account for their welfare or physiology, leading to reduced longevity and consequently high annual replacement. The European Food Safety Authority (EFSA) recommends limited and infrequent use of hormone treatments, and suggests replacement with alternative methods that do not threaten animal welfare when possible. In the present study, we aimed to determine whether the GnRH analogue lecirelin acetate could be administered by inclusion in the seminal dose during insemination. Twenty 9-month-old does (Grigio del Monferrato, autochthonous Italian breed),each having two previous deliveries, were individually housed and divided into two groups at artificial insemination. The control group received 0.2 mL of intramuscular lecirelin (Dalmarelin, Fatro®, Italy) prior to insemination. The intravaginal group was inseminated with a seminal dose that included 0.3 mL Dalmarelin. The experiment was performed for six consecutive reproductive cycles at 42-day intervals, and included a total of 120 inseminations. Prior to each insemination, the heterospermic pooled semen samples were assessed for sperm motility and morphology. Each ejaculate was divided into two samples, with and without lecirelin addition. Compared to the control group, the does with intravaginal Dalmarelin administration showed equal or greater sexual receptivity, which resulted in a higher fertility rate over increasing cycles. The seminal dose volume was very low, possibly explaining the better results in the intravaginal group, which received a similar amount of hormone (0.3 mL/doe) as the control group (0.2 mL/doe). The negative performance of the control group may have also been due to anti-GnRH formation, and the more stressful method of ovulation induction. The number of live-born kits did not significantly differ between groups. Progressive motility was significantly positively correlated with motility characteristics, including VAP, VSL, ALH, BCF, STR, and LIN. Overall, our present findings supported that the incorporation of GnRH in a seminal dose could be used for ovulation induction in rabbit does. Further studies should identify the optimal dose of GnRH for intravaginal administration, taking into account that the intravaginal absorption capacity is about 10 times smaller than the intramuscular absorption capacity.

The performance of benthic indicators of ecological change in Adriatic coastal lagoons: throwing the baby with the water?

The ecological quality of 127 stations from six Adriatic coastal lagoons was assessed using a suite of biotic indices: H', d, 1-lambda', Delta(*), Delta(+), W, AMBI, BOPA and FINE. The analysis indicated the difficulties in deriving and using the existing indices from benthic communities in highly variable environmental conditions in coastal lagoons. Different metrics rendered different results: the use of H' resulted in the classification of all stations as "Moderate/Poor/Bad", whereas BOPA classified the majority of the stations as "Good/High". Using Delta(+), most of the stations resulted as "Not anthropogenically impacted", while the W-statistics gave 82 stations as "Undisturbed" and 45 as "Moderately/Grossly disturbed". AMBI classified 55 stations as "High/Good" and 72 as "Moderate/Poor/Bad", whereas those were 32 and 95 with FINE, respectively. The latter, which was developed just for Italian coastal lagoons, was the most conservative among the indices studied. Yet, it showed the highest correlation with the species/abundance matrix. Using indices developed for coastal waters in lagoons can give the distorted indication that the water body is degraded, when it might be just a natural, low diversity, high abundance community, i.e. a lagoonal community. Moreover, the outcome of the use of a certain index has a financial dimension such that lagoons misclassified as being "poor status" will then require expensive remediation measures. For the lagoons studied, there is probably an adequate quality and quantity of benthic data available for making management decisions, but this study highlights the limits of the existing indices for lagoonal ecosystems. The challenge for the next future is to couple long term conservation of the natural environment with the highly productive activities carried out in lagoonal ecosystems.

Assessing the effectiveness of surrogates for species over time: Evidence from decadal monitoring of a Mediterranean transitional water ecosystem.

The use of higher taxa or alternative approach to species surrogacy, such as the BestAgg procedure, could represent cost-effective solutions to avoid expensive species-level identifications in monitoring activities, especially on the long term. However, whether a set of surrogates would be effective in subsequent reiteration of the same assessment remains largely unsolved. We used a long-term dataset on macro-benthic assemblages to test the hypothesis that family-level and BestAgg surrogates which are effective for a limited period of monitoring could be successfully applied to quantify community patterns also in subsequent monitoring programmes. The effectiveness of surrogates in detecting temporal variations in assemblage structure as at species level remained basically unaffected over a decade. Recognizing once and for all if species surrogacy may have a practical value for monitoring will strongly depend on future assessments of the potential of surrogates to reflect community changes and to retain this prerogative over time.

Taylor's cortical dysplasia: a confocal and ultrastructural immunohistochemical study.

In the present report we describe the neuropathological characteristics of tissue surgically resected from three patients affected by intractable epilepsy secondary to cortical dysplasia. Common features, suggestive of a focal cortical dysplasia of Taylor, were observed in all specimens. Immunocytochemical procedures were performed using neuronal and glial markers and the sections were observed at light traditional and confocal microscopes. This part of the investigation pointed out: 1. cortical laminar disruption; 2. very large neurons displaying a pyramidal or round shape; 3. ballooned cells; 4. decrease of calcium binding proteins immunoreactivity; 5. abnormal nets of parvalbumin- and glutamic acid decarboxylase-positive puncta around giant neurons but not around ballooned cells. Ultrastructural investigation on the same material provided evidence of a high concentration of neurofilaments in giant neurons and of glial intermediate filaments in ballooned cells. In addition, immunolabeled GABAergic terminals clustered around giant neurons were not found to establish synapses on their cell bodies. The present data, derived from a limited sample of patients but showing very consistent features, suggest that in Taylor's type of cortical dysplasia a disturbance of migratory events could be paralleled by a disruption of cell differentiation and maturation and by an impairment of synaptogenesis. This latter mechanism seemed to affect especially the inhibitory elements, and could account for the hyperexcitability of this tissue and thus for the high epileptogenicity of Taylor's dysplasia.

Stereo-electroencephalography methodology: advantages and limits.

Since January 1990, 70 patients with medically intractable partial epilepsy underwent a stereo-EEG investigation in our center. We first described technical requirements, and gave an overview of the variety of the explored cerebral regions and implantation patterns realized, pointing out the low rate of morbidity (1.4%). The three-dimensional epileptogenic zone thus defined led to a tailored individualized surgical excision in 60 patients, while 9 are waiting for surgery and the remaining 1 has been excluded (1.4%). Conceptual and technical aspects of the stereo-EEG methodology were discussed in order to underline its peculiarities in the field of "depth recordings", and more generally among the broader group of "invasive" procedures.

Brain regional pharmacokinetics of 11C-labeled diphenylhydantoin: positron emission tomography in humans.

We used positron emission tomography to study the regional cerebral pharmacokinetics of 11C-labeled diphenylhydantoin (11C-DPH), which was given intravenously to 10 patients (8 intractable partial epileptics and 2 nonepileptics). In the nonaffected hemisphere, 11C-DPH concentration in gray matter reached equilibrium with blood within 20 minutes but was still rising at 60 minutes in white matter, where equilibrium was too slow to be detected owing to the fast physical decay of 11C. Brain-blood concentration ratios at 50 minutes were 1.37 and 1.06 in gray and white matter, respectively, similar but less variable than steady-state DPH ratios reported in human brain surgical samples. There was no indication that normal brain regions of medically resistant epileptics bind DPH less effectively than in nonepileptic patients. Brain and blood 11C-DPH concentrations were well correlated, confirming that the latter gives a reliable estimate of the former in unaffected brain regions.

Selective block of rat and human neocortex GABA(B) receptors regulating somatostatin release by a GABA(B) antagonist endowed with cognition enhancing activity.

Previously, we have shown that presynaptic GABA(B) receptors regulating the release of various transmitters from CNS terminals can be differentially blocked by GABA(B) antagonists suggesting the existence of pharmacologically distinct GABA(B) receptor subtypes. We here examined the ability of CGP 36742 [(3-aminopropyl)n-butylphosphinic acid], a selective GABA(B) antagonist endowed with cognition enhancing activity, to block release-regulating GABA(B) receptors. In particular, CGP 36742 was tested against the inhibition of the depolarization-evoked release of GABA, glutamate, cholecystokinin and somatostatin produced by (-)baclofen in rat and human neocortex axon terminals. CGP 36742 potently antagonized (IC50 = 0.14 microM) the inhibition by (-)baclofen of somatostatin release from superfused rat neocortex synaptosomes. In contrast, the effects of (-)baclofen on GABA, glutamate and cholecystokinin release were insensitive to CGP 36742, at concentrations of up to 100 microM. In human neocortex synaptosomes CGP 36742 exhibited a pattern of selectivity identical to that in rat synaptosomes, although the antagonist was at least 10-fold less potent in human than in rat brain. CGP 36742 is the first compound displaying great selectivity for the GABA(B) presynaptic receptors regulating somatostatin release. Considering the proposed implication of the neuropeptide in cognitive processes, disinhibition of somatostatin release merits consideration as one of the mechanisms possibly involved in the behavioral activity of CGP 36742.

Activation of brain nitric oxide synthase in depolarized human temporal cortex slices: differential role of voltage-sensitive calcium channels.

1. Nitric oxide (NO) synthase activity was studied in slices of human temporal cortex samples obtained in neurosurgery by measuring the conversion of L-[3H]-arginine to L-[3H]-citrulline. 2. Elevation of extracellular K+ to 20, 35 or 60 mM concentration-dependently augmented L-[3H]-citrulline production. The response to 35 mM KCl was abolished by N(G)-nitro-L-arginine (100 microM) demonstrating NO synthase specific conversion of L-arginine to L-citrulline. Increasing extracellular MgCl2 concentration up to 10 mM also prevented the K+ (35 mM)-induced NO synthase activation, suggesting the absolute requirement of external calcium ions for enzyme activity. 3. However, the effect of high K+ (35 mM) on citrulline synthesis was insensitive to the antagonists of ionotropic and metabotropic glutamate receptors dizocilpine (MK-801), 6-nitro-7-sulphamoylbenzo(f)-quinoxaline-2-3-dione (NBQX) or L-2-amino-3-phosphonopropionic acid (L-AP3) as well as to the nicotinic receptor antagonist, mecamylamine. 4. The 35 mM K+ response was insensitive to omega-conotoxin GVIA (1 microM) and nifedipine (100 microM), but could be prevented in part by omega-agatoxin IVA (0.1 and 1 microM). The inhibition caused by 0.1 microM omega-agatoxin IVA (approximately 30%) was enhanced by adding omega-conotoxin GVIA (1 microM) or nifedipine (100 microM). Further inhibition (up to above 70%) could be observed when the three Ca2+ channel blockers were added together. Similarly, synthetic FTX 3.3 arginine polyamine (sFTX) prevented (50% at 100 microM) the K+-evoked NO synthase activation. This effect of sFTX was further enhanced (up to 70%) by adding 1 microM omega-conotoxin GVIA plus 100 microM nifedipine. No further inhibition could be observed upon addition of MK-801 or/and NBQX. 5. It was concluded that elevation of extracellular [K+] causes NO synthase activation by external Ca2+ entering cells mainly through channels of the P/Q-type. Other Ca2+ channels (L- and N-type) appear to contribute when P/Q-channels are blocked.

Pharmacological diversity between native human 5-HT1B and 5-HT1D receptors sited on different neurons and involved in different functions.

The releases of [3H]5-hydroxytryptamine ([3H]5-HT) and of endogenous glutamic acid and their modulation through presynaptic h5-HT1B autoreceptors and h5-HT1D heteroreceptors have been investigated in synaptosomal preparations from fresh neocortical samples obtained from patients undergoing neurosurgery. The inhibition by 5-HT of the K+ (15 mM)-evoked overflow of [3H]5-HT was antagonized by the 5-HT1B/5-HT1D receptor ligand GR 127935, which was ineffective on its own; this drug was previously found to behave as a full agonist at the h5-HT1D heteroreceptor regulating glutamate release. The recently proposed selective h5-HT1B receptor ligand SB-224289 also prevented the effect of 5-HT at the autoreceptor, being inactive on its own; in contrast, SB-224289, at 1 microM, was unable to interact with the h5-HT1D heteroreceptor. The inhibitory effect of 5-HT on the K+-evoked overflow of glutamate was antagonized by the h5-HT1D receptor ligand BRL-15572; added in the absence of 5-HT the compound was without effect. BRL-15572 (1 microM) was unable to modify the effect of 5-HT at the autoreceptor regulating [3H]5-HT release. The selective 5-HT1A receptor antagonist (+)-WAY 100135, previously found to be an agonist at the h5-HT1D heteroreceptor regulating glutamate release, could not interact with the h5-HT1B autoreceptor when added at 1 microM. It is concluded that native h5-HT1B and h5-HT1D receptors exhibit a hitherto unexpected pharmacological diversity.

Sleep-EEG modulation of interictal epileptiform discharges in adult partial epilepsy: a spectral analysis study.

INTRODUCTION: In order to define accurately the relationship between EEG components (spindles, delta and theta frequencies) and the occurrence of interictal epileptiform discharges (IED) during sleep in partial epilepsy, a correlation study between spike overnight distribution and EEG spectral power time series was performed. METHODS: Eighteen patients (mean age: 24.7+/-5.5 years) affected by partial epilepsy underwent continuous EEG-polysomnography. The temporal series of Slow Wave Activity (SWA), Sigma Activity (SA) and Theta Band (TB), derived from spectral analysis, were obtained from a spike-free and pathologic alteration-free derivation, contralateral to the most active lead, where the IED count was performed. Relationships between SA, SWA and TB and time series of IED were tested by means of correlation techniques after data normalization. RESULTS: Our results revealed a significantly higher correlation between IED and SWA in 12 subjects; a significantly higher correlation between IED and SA in three subjects and a significant correlation with TB in three cases. CONCLUSIONS: Data suggest that in most adult patients with partial epilepsy IED production during sleep is facilitated by the action of synchronizing mechanisms which are active during NREM sleep and lead to the appearance of EEG delta waves. Nevertheless evidence is given of two smaller groups of patients. In one of them IED are more sensitive to the promoting action of the spindle generating mechanism, active during stage 2 of NREM sleep. In the other one the promoting action of TB, characterizing EEG during stage 1 and REM sleep, is evident.

Stereotactic radiosurgery with the linear accelerator: treatment of arteriovenous malformations.

An original stereotactic radiosurgical approach coupling a) Talairach's stereotactic methodology, b) a specially devised mechanical system, and c) a linear accelerator is detailed. The authors present their preliminary results on 66 patients with nonsurgical intracranial arteriovenous malformations. The doses delivered for treatment varied from 20 to 70 Gy. Doses of no more than 40 Gy were used in 80% of patients. An angiographic study was performed when the computed tomographic scan controls showed relevant modifications of the lesion volume. Total obliteration was obtained in 27 of the 41 patients (65.8%) who were followed up for at least 24 months. The percentage of the cured patients is significantly higher when a) the entire malformation is included in the 75% isodose (96%) and b) the maximum diameter of the lesion is less than 12 mm (81%). Two patients died of rebleeding at 18 and 29 months after treatment.

Immunocytochemical investigation on dysplastic human tissue from epileptic patients.

In this report we describe three patients with developmental cortical abnormalities (generally referred as cortical dysplasia), revealed by MRI and operated on for intractable epilepsy. Tissue, removed for strictly therapeutic reasons, was defined as the epileptogenic area by electroclinical data and stereo EEG (SEEG) recordings. Tissue samples were processed initially for histology, and selected sections were further processed for immunocytochemical investigation in order to determine whether the region of cortical dysplasia was co-extensive with the epileptogenic area. In two patients with nodular heterotopia, disorganized aggregates of neurons (as revealed by neuronal cytoskeletal markers) were found within the nodules. Both pyramidal and local circuit neurons were present in the nodules, but no reactive gliosis was present. When nodules reached the cortex, the cortical layers were disrupted. In the patient with localized cortical dysplasia, a complete disorganization of the cortical lamination was found, and numerous neurons were also present in the white matter. Disoriented pyramidal neurons weakly labelled with cytoskeletal neuronal markers were also present but no cytomegalic cells were found. One of the patients with nodular heterotopia underwent only partial resection of both the 'epileptogenic area' and of the lesion; this patient still presents with seizures. The other patient with nodular heterotopia is seizure-free after a complete lesionectomy and excision of the epileptogenic area. The third patient, with focal cortical dysplasia, had two surgeries; she became seizure-free only after the excision of the epileptogenic area detected by SEEG recording. The present data suggest that the dysplastic areas identified by MRI should not be considered as the only place of origin of the ictal discharges. From the neuropathological point of view, the focal cortical dysplasia can be considered as a pure form of migrational disorder. However, the presence of large aggregates of neurons interspersed within the white matter, in the subcortical nodular heterotopia, suggests that a defect of neuronal migration could be associated with an exuberant production of neuroblasts and/or a disruption of mechanisms for naturally occurring cell death.

Alterations of GABA-mediated synaptic transmission in human epilepsy.

Although animal models consistently indicate that gamma-amino-butyric acid (GABA) synaptic function (GABA levels, synthesis, uptake and/or receptors) is decreased in seizure states, there is little evidence to date in support of such a hypothesis for human epilepsy. This chapter presents the results of an in-depth study of the activity of the GABA-synthesizing enzyme L-glutamic acid decarboxylase (GAD) in brain tissue removed during neurosurgical resection for intractable epilepsy. The tissue studied is unique in that identified (by stereo EEG) foci were excised (rather than large blocks of tissue containing mixtures of foci and nonepileptic material) and compared with nonepileptic (stereo EEG and morphological definitions) tissue from the same patients. In patients in which there was no indication of a tumor, GAD activity in the foci was low in more than 50% of the patients examined. Furthermore, when the population distribution of GAD was compared in epileptic versus nonepileptic tissue fragments from all patients, the peak distribution of epileptic tissue fragments occurred at much lower GAD activities than for the nonepileptic fragments (0-20 versus 41-80 nmol CO2/mg protein X hr, respectively). A small subgroup of epileptic fragments occurred with a normal GAD distribution, indicating that the presence of an epileptic focus was not invariably associated with low GAD activity. When the low levels of GABA "A" binding sites in these epileptic tissue fragments are taken into consideration in combination with the low GAD levels, then it can be estimated that 60 to 70% of the present patient population had deficient GABAergic transmission in epileptic foci as compared to nonepileptic brain tissue from the same patients. It follows that the GABA hypothesis of human epilepsy is not an exclusive or unitary hypothesis, and some patients appear to have normally functioning GABA synapses (as assessed biochemically) in epileptogenic areas. Thus, other neurotransmitter and neurohumoral systems certainly play a role in the epileptic process.

Surgical therapy for frontal epilepsies.

We have described our 25 years experience concerning 100 patients operated on for frontal epilepsy. Results show that 55% of patients are practically cured of their seizures and that 76% benefited from cortectomy (reduction of more than 75% of seizures). These results are the worst in the total series of St. Anne. Reasons for success and especially failure were analyzed in detail: 1. SEEG methods gave good indications along three dimensions of the limits and borders of the cortical excision. 2. When clinical semiology and organization of ictal discharges give evidence for rapid bilateral discharge, with involvement of axial musculature and generalized tonic-clonic manifestations, experience shows that it is necessary to combine cortectomy with a section of the adjacent cortico-subcortical fibers of the corona radiata, as if propagation of ictal discharges were impeded if not interrupted by sectioning such fibers and the primary site were incapable of expressing itself clinically. 3. If the characteristics of seizures suggest the quasisimultaneous involvement of the two frontal lobes and the existence of bilateral multifocal epilepsy, we suggest that a systematized anterior callosotomy might lead to useful results. 4. Finally, we propose general criteria for indications and contraindications for surgery.

[Introduction to the clinical study of postrolandic epileptic seizures]. / Introduction à l'etude clinique des crises epileptiques rétrorolandiques.

We reviewed, in 145 epilectics studied with SEEG, 800 clinical and electrographic seizures originating from the post-rolandic areas (590 spontaneous Sz and 260 induced by stimulation). The intra-cranial electrodes were implanted using a technique described by Talairach et al. (1974). Seizure onsets were recorded in the centro-parietal region (64 patients) in the parietal and in the occipital region. Additionally in 15 patients, mixed Sz onset were recorded. One hundred and eight (108) patients underwent surgical removal of their epileptic focus. (69 on the right, 39 on left.) 65% were cured (Sz free or occas Sz, f/up 3 years). The main ictal cal features are discussed. Emphasis is placed on the role of the operculo-insular cortex in the functional organization in man, based on Sz arising from the supra-temporal (fronto-pariental) cortex. The study of the pattern of onset and spread of seizures originating in the post-rolandic areas and of their clinical correlates allow a topographic differential diagnosis.

[Electroclinical manifestations elicited by intracerebral electric stimulation "shocks" in temporal lobe epilepsy]. / Manifestations électrocliniques induites par la stimulation électrique intracérébrale par "chocs" dans les épilepsies temporales.

In patients with severe drug-resistant partial epilepsy, undergoing Stereo-EEG investigations, spatial definition of the "epileptogenic area" is mainly based on spontaneous seizures recordings, but also on seizures induced by intracerebral electrical stimulation (ES). Only "trains" ES (TES, 50 pps) are currently used with this aim; "shocks" ES (SES, 1 pps) are principally applied to localize motor pathways. We have shown, during a prospective study concerning 10 temporal lobe epileptic patients, that SES could frequently induce seizures, especially when stimulation is applied in the anterior part of the Ammon's horn. Even if its efficacy seems lower than by TES, this kind of stimulation, in the majority of the cases, does reproduce isolated ictal subjective symptomatology, allowing the visualization of the progressive organisation of ictal electrical discharges, and avoids "unexpected" ("false positive"?) clinical responses.

Epilepsy surgery: guidelines for minimum standard equipment and organization.

These guidelines, developed by the Study Group on Functional Neurosurgery of the Italian Society of Neurosurgery, concern the minimum standard equipment and organization required to a center dealing with the surgical treatment of epilepsy. They include the general criteria for patient selection, the main presurgical diagnostic procedures able to define seizure characteristics and concomitant brain abnormalities, the standard surgical procedures utilized. "Cryptogenetic" as well as "symptomatic" epilepsies are considered. Recommendations are also provided for correct result assessment and follow-up evaluation. Guidelines presented here reflect a multidisciplinary consensus and expert opinion, based on scientific evidence and current clinical experience.

Stereotactic endocavitary treatment of cysts and pseudocysts of glioma. Preliminary report.

The present study reports the results of the stereotactic treatment via endocavitary irradiation (Talaraich's method) of 50 gliomatous cysts (volume: 5-242 cm3; av.: 73 cm3) in 45 patients (M: 24; F: 21; age 3.5-57 yrs; av.: 22 yrs) in the period January 1973-January 1987. Twenty-four patients (27 cysts) were affected by a grade I glioma, 10 patients (12 cysts) by a grade II and 11 patients (11 cysts) by a grade III or IV glioma. The first step in the treatment was a neuroradiological stereotactic stereoscopical survey (tele-angiography, ventriculography, cystography) with serial biopsies and a cystic impermeability test (injection of 0.3-1 mCi of Re 186). One week later one therapeutic dose, ranging between 5 and 85 mCi of a beta-emitting colloidal radioisotope (Re 186, Au 198, Y 90), was stereotactically injected into the cyst. The stereotactic treatment was not followed by severe side effects. In high grade gliomas (grade III and IV) the benefit of the possible shrinkage and/or disappearance of the cyst was vanished by the solid tumor progression. In low grade gliomas (grade I and II) more than 50% of the cysts disappeared and 25% of them shrinked up to one third of the starting volume (follow-up: 5-168 mo.; av.: 54 mo.). At present almost only Re 186 is employed using a cyst wall dose of 400-500 Gys. The low surgical invasiveness, the absence of severe side effects and good therapeutical results induce us to propose this as a first choice treatment in inoperable low grade gliomatous expanding cysts.

Long term results of stereotactic endocavitary beta irradiation of craniopharyngioma cysts.

This study concerns 33 pts (age: 3-69 yrs; m: 22) with cystic craniopharyngiomas (36 cysts) treated with stereotactic beta endocavitary irradiation (TRT). Nine patients died (3 days to 36 months after TRT) and one was lost. In 23 the follow-up varied from 12 to 126 months (m: 45 months). The disappearance of 13 cysts was appreciated 5 to 24 months after TRT: no recurrence was observed after 22-126 months (m: 61). A greater than 70% reduction of the cyst volume occurred 3-36 months after TRT and persisted at 12-71 months (m: 35 m). In one patient, the cyst volume increased. Visual acuity improved in more than 50% of survivors, while endocrine disturbances did not change and memory troubles disappeared.

Inter-ictal brain SPET in frontal epilepsy: correlations with stereo-electroencephalography.

Single photon emission tomography (SPET) imaging holds promise for localization of the site of extratemporal seizures, but limited data currently exist; in particular, correlations with stereo-electroencephalography (S-EEG) have not been made. Ten patients aged 14-44 years (mean 25 years) with a proven frontal or central epilepsy by S-EEG and post-surgical follow-up were studied retrospectively: 7 patients had frontal cortectomy and one patient had a callosotomy for bifrontal epilepsy. All patients underwent clinical, inter-ictal and ictal video-EEG, computed tomography scan and/or magnetic resonance imaging, SPET and S-EEG examinations. SPET was performed inter-ictally, while on usual epileptic medications, using 99Tcm-HMPAO (n = 4) or 123I-IMP (n = 6) as the perfusion tracer. The SPET images were evaluated independently by two observers, blind to any data other than the diagnosis of frontral or central epilepsy. Localization of inter-ictal SPET hypoperfusion was compared with the epileptogenic (EZ), irritative (IZ) and lesional (LZ) zones, as defined by S-EEG. Six patients showed structural frontal abnormalities. One patient had normal SPET and one had a contralateral hypoperfusion. Therefore, concordance of sides was found in 8 of 10 patients (including one with bilateral SPET and S-EEG abnormalities). The hypoperfusion was equal to or larger than the EZ + IZ + LZ in 6 patients (5 had a frontal lesion). SPET hypoperfusion was smaller than the EZ in one patient, and different from the EZ, IZ and LZ in two patients. Although this was a retrospective study, it provides qualitative data regarding the significance of inter-ictal SPET abnormalities in frontal or central epilepsy.(ABSTRACT TRUNCATED AT 250 WORDS)