RT Journal Article
SR Electronic
T1 Focal structural changes and cognitive dysfunction in juvenile myoclonic epilepsy
JF Neurology
JO Neurology
FD Lippincott Williams & Wilkins
SP 34
OP 40
DO 10.1212/WNL.0b013e318203e93d
VO 76
IS 1
A1 J. O'Muircheartaigh
A1 C. Vollmar
A1 G.J. Barker
A1 V. Kumari
A1 M.R. Symms
A1 P. Thompson
A1 J.S. Duncan
A1 M.J. Koepp
A1 M.P. Richardson
YR 2011
UL http://n.neurology.org/content/76/1/34.abstract
AB Objective: The aim of this study was to determine if there were focal cortical abnormalities in juvenile myoclonic epilepsy (JME) using neuropsychological investigations and MRI. Methods: Twenty-eight patients with JME and a large sample of healthy controls were assessed using a series of neuropsychological tests as well as structural and diffusion tensor MRI (DTI). DTI measures assessed fractional anisotropy (FA) within a white matter skeleton. Results: Neuropsychological testing indicated subtle dysfunctions in verbal fluency, comprehension, and expression, as well as nonverbal memory and mental flexibility. Utilizing whole-brain voxel-based morphometry for gray matter MRI data and tract-based spatial statistics for white matter diffusion MRI data, we found reductions in gray matter volume (GMV) in the supplementary motor area and posterior cingulate cortex and reductions in FA in underlying white matter of the corpus callosum. Supplementary motor area FA predicted scores in word naming tasks and expression scores. Posterior cingulate cortex GMV and FA predicted cognitive inhibition scores on the mental flexibility task. Conclusions: The neuropsychological, structural, and tractography results implicate mesial frontal cortex, especially the supplementary motor area, and posterior cingulate cortex in JME.