This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.
Abstract
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.
Footnotes
-
Study funding: Supported by the Wellcome Trust (project grant no. 079474) and the Big Lottery Fund, Wolfson Trust, and the National Society for Epilepsy (NSE) for supporting the NSE MRI scanner. Infrastructure support was provided by the National Institute for Health Research (NIHR) Specialist Biomedical Research Centre for Mental Health at the South London and Maudsley NHS Foundation Trust and the Institute of Psychiatry, King's College London. Part of this work was undertaken at University College London Hospitals, who received a proportion of funding from the National Institute for Health Research, Biomedical Research Centres funding scheme.
-
Supplemental data at www.neurology.org
-
- DTI
- diffusion tensor MRI
- FA
- fractional anisotropy
- GLX
- glutamine
- GMV
- gray matter volume
- IGE
- idiopathic generalized epilepsy
- JME
- juvenile myoclonic epilepsy
- MNI
- Montreal Neurological Institute
- MRS
- magnetic resonance spectroscopy
- NAA
- N-acetylaspartate
- SMA
- supplementary motor area
- SPGR
- spoiled gradient echo
- TBSS
- tract-based spatial statistics
- VBM
- voxel-based morphometry
- Received March 29, 2010.
- Accepted September 30, 2010.
- Copyright © 2010 by AAN Enterprises, Inc.
AAN Members
We have changed the login procedure to improve access between AAN.com and the Neurology journals. If you are experiencing issues, please log out of AAN.com and clear history and cookies. (For instructions by browser, please click the instruction pages below). After clearing, choose preferred Journal and select login for AAN Members. You will be redirected to a login page where you can log in with your AAN ID number and password. When you are returned to the Journal, your name should appear at the top right of the page.
AAN Non-Member Subscribers
Purchase access
Letters: Rapid online correspondence
REQUIREMENTS
You must ensure that your Disclosures have been updated within the previous six months. Please go to our Submission Site to add or update your Disclosure information.
Your co-authors must send a completed Publishing Agreement Form to Neurology Staff (not necessary for the lead/corresponding author as the form below will suffice) before you upload your comment.
If you are responding to a comment that was written about an article you originally authored:
You (and co-authors) do not need to fill out forms or check disclosures as author forms are still valid
and apply to letter.
Submission specifications:
- Submissions must be < 200 words with < 5 references. Reference 1 must be the article on which you are commenting.
- Submissions should not have more than 5 authors. (Exception: original author replies can include all original authors of the article)
- Submit only on articles published within 6 months of issue date.
- Do not be redundant. Read any comments already posted on the article prior to submission.
- Submitted comments are subject to editing and editor review prior to posting.
You May Also be Interested in
Costs and Utilization of New-to-Market Neurologic Medications
Dr. Robert J. Fox and Dr. Mandy Leonard
► Watch
Topics Discussed
Alert Me
Recommended articles
Microstructural white matter changes in cognitively normal individuals at risk of amnestic MCI
Diffusion tensor MRI changes in cerebellar structures of patients with familial essential tremor
Characterizing dementia with Lewy bodies by means of diffusion tensor imaging
White matter abnormalities in the corpus callosum with cognitive impairment in Parkinson disease