Ara Garabed Kaprelyan graduated from Higher Medical Institute of Varna in 1988. He is a Specialist in Neurology and Health Management, PhD since 2005, and Professor since 2013. Recently, he is a Chief of First Clinic of Neurology, member of Advisory Council (Neurology division) at University Multiprofi le Hospital for Active Treatment “Sveta Marina", Varna. He is an expert in MS, PD, AD, epilepsy, and chronic pain at National Health Insurance Fund and Republican Consultant of Ministry of Health for North-East region of Bulgaria. He is Head of Department of Neurologic Diseases and Neurosciences
at Varna Medical University. His Postgraduate education includes specialization in neuro-oncology, clinical immunology, otoneurology, clinical epileptology, and movement disorders. He has over 150 scientifi c publications and authorship in eight medical text-books and monographs. He is a Member of Bulgarian Society of Neurology (Board of Managers; Chairman of regional branch at Varna district), Bulgarian Association of Neuro-oncology
(Vice-president), International Medical Association Bulgaria, Balkan Medical Union (Vice-president of Bulgarian branch), and EAN (scientifi c panels of neuroepidemiology and neuro-oncology). He is in the Editorial Board of Journal of IMAB and Bulgarian Neurology, as well as a Correspondent member of Bulgarian Academy of Sciences and Arts.
Recent epidemiological studies reveal increasing incidence and prevalence of patients with dementia
and epilepsy. Nuclear imaging techniques are modern non-invasive tools for investigation in vivo of the basic CNS biochemical
processes and physiological functions. Positron emission tomography (PET) provides information about cerebral blood fl ow (CBF), permeability of blood-brain barrier (BBB), cerebral enzyme activity, as well as glucose, amino acids, and neurotransmitters metabolism. Accordingly, it is among the most useful biomarkers for evaluation of neurodegeneration
in dementia. (18F)-FDG PET may uncover the disease underlying mechanisms, follow-up the progression, and predict the outcome. Also, interictal PET is used to detect the seizure onset zone and determine the lateralization of temporal lobe epilepsy, when a good concordance between MRI and EEG is missing.
Objective: To study the (18F)-FDG PET fi ndings in patients with dementias and epilepsy.
Patients with diff erent clinical forms of dementia, genetic and structural epilepsy
, due to congenital or acquired brain lesions were included in the study. Detailed clinical examination, MRI and (18F)-FDG PET (Philips Gemini TF PET/CT) were performed.
Decreased glucose metabolism, predominantly in the temporal and parietal regions was found in patients with Alzheimer’s
. Th e degree of hypometabolic disturbances correlated with the severity of the disease. In patients with diff use Lewy body
disease (18F)-FDG PET revealed metabolic changes similar to the AD abnormalities and additional hypometabolism in the regions
of visual cortex. In patients with FTD zones of hypometabolism in frontal and temporal lobes were illustrated. Multiple foci of hypometabolism
, corresponding to the disturbances of cerebral blood fl ow were shown on scans of patients with vascular dementia.
Interictal (18F)-FDG PET demonstrated well-defi ned hypometabolic zones in accordance with the location of epileptic foci.
Conclusion: Based on our own notices, we suggest that (18F)-FDG PET is a useful eff ective method for early detection and precise
diagnosis of dementias epilepsy.