4.7 Article

Focal structural changes and cognitive dysfunction in juvenile myoclonic epilepsy

Journal

NEUROLOGY
Volume 76, Issue 1, Pages 34-40

Publisher

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1212/WNL.0b013e318203e93d

Keywords

-

Funding

  1. GE Healthcare
  2. Medical Research Council UK
  3. Wellcome Trust [079474]
  4. Guy's and St Thomas
  5. Epilepsy Research UK
  6. Baily Thomas Charitable Fund
  7. Janssen-Cilag
  8. Desitin Pharmaceuticals
  9. GmbH
  10. UCB
  11. Pfizer Inc.
  12. MRC
  13. EU
  14. Funding Janssen Cilag
  15. Eisai Inc.
  16. Charles Sykes Memorial Fund
  17. King's Medical Research Trust
  18. Getty Family Foundation
  19. Big Lottery Fund
  20. Wolfson Trust
  21. National Society for Epilepsy (NSE)
  22. National Institute for Health Research (NIHR) Specialist Biomedical Research Centre for Mental Health at the South London and Maudsley NHS Foundation Trust
  23. Institute of Psychiatry, King's College London
  24. National Institute for Health Research, Biomedical Research Centres funding scheme
  25. National Institute for Health Research [NF-SI-0509-10161] Funding Source: researchfish

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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. Neurology (R) 2011; 76:34-40

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