Skip to main content
AAN.com

Abstract

Background: Juvenile myoclonic epilepsy (JME) is a syndrome of idiopathic generalized epilepsy (IGE) without structural brain abnormalities detectable by MRI or CT.
Objective: In the present study, we addressed the question of whether diffusion tensor MRI (DTI) can detect disease-specific white matter (WM) abnormalities in patients with JME.
Methods: We performed whole head DTI at 3 T in 10 patients with JME, 8 age-matched patients with cryptogenic partial epilepsy (CPE), and 67 age-matched healthy volunteers. Nerve fiber integrity was compared between the groups on the basis of optimized voxel-by-voxel statistics of fractional anisotropy (FA) maps obtained by DTI (analysis of covariance, categorical factor “group,” covariate “age”).
Results: FA was reduced in a WM region associated with the anterior thalamus and prefrontal cortex in patients with JME compared to both control subjects and patients with CPE (p < 0.001). The patients with CPE showed normal values in this particular WM region. The FA reductions in the patients with JME correlated with the frequency of generalized tonic-clonic seizures (Spearman R = 0.54, p = 0.05). No significant correlations were found in the JME sample between FA reduction and the duration of antiepileptic medication.
Conclusions: The results support the hypothesis that juvenile myoclonic epilepsy is associated with abnormalities of the thalamocortical network that can be detected by diffusion tensor MRI.
CPE = cryptogenic partial epilepsy; DTI = diffusion tensor imaging; EPI = echoplanar imaging; FA = fractional anisotropy; GMC = gray matter concentration; GTCS = generalized tonic-clonic seizures; IGE = idiopathic generalized epilepsy; JME = juvenile myoclonic epilepsy; MNI = Montreal Neurological Institute; ROI = region of interest; VBM = voxel based morphometry; WM = white matter.

Get full access to this article

View all available purchase options and get full access to this article.

Supplementary Material

File (deppe.pdf)
File (e1.pdf)
File (e2.pdf)
File (e3.pdf)

REFERENCES

1.
Janz D. Die Epilepsien. Stuttgart: Georg Thieme Verlag;
2.
Loddenkemper T, Benbadis SR, Serratosa JM, Berkovic SF. Idiopathic generalized epilepsy syndromes of childhood and adolescence. In: Wyllie E, Gupta A, Lachhwani DK, eds. The Treatment of Epilepsy: Principles and Practice. Philadelphia: Lippincott Williams & Wilkins;
3.
Meencke HJ, Janz D. Neuropathological findings in primary generalized epilepsy: a study of eight cases. Epilepsia 1984;25:8–21.
4.
Meencke HJ. Neuron density in the molecular layer of the frontal cortex in primary generalized epilepsy. Epilepsia 1985;26:450–454.
5.
Lyon G, Gastaut H. Considerations on the significance attributed to unusual cerebral histological findings recently described in eight patients with primary generalized epilepsy. Epilepsia 1985;26:365–367.
6.
Opeskin K, Kalnins RM, Halliday G, Cartwright H, Berkovic SF. Idiopathic generalized epilepsy: lack of significant microdysgenesis. Neurology 2000;55:1101–1106.
7.
Savic I, Lekvall A, Greitz D, Helms G. MR spectroscopy shows reduced frontal lobe concentrations of N-acetyl aspartate in patients with juvenile myoclonic epilepsy. Epilepsia 2000;41:290–296.
8.
Savic I, Osterman Y, Helms G. MRS shows syndrome differentiated metabolite changes in human-generalized epilepsies. Neuroimage 2004;21:163–172.
9.
Mory SB, Li LM, Guerreiro CA, Cendes F. Thalamic dysfunction in juvenile myoclonic epilepsy: a proton MRS study. Epilepsia 2003;44:1402–1405.
10.
Haki C, Gumustas OG, Bora I, Gumustas AU, Parlak M. Proton magnetic resonance spectroscopy study of bilateral thalamus in juvenile myoclonic epilepsy. Seizure 2007;16:287–295.
11.
Beaulieu C, Allen PS. Determinants of anisotropic water diffusion in nerves. Magn Reson Med 1994;31:394–400.
12.
Deppe M, Duning T, Mohammadi S, et al. Diffusion-tensor Imaging at 3 T: detection of white matter alterations in neurological patients on the basis of normal values. Invest Radiol 2007;42:338–345.
13.
Kleffner I, Deppe M, Mohammadi S, et al. Diffusion tensor imaging demonstrates fiber impairment in Susac syndrome. Neurology 2008;70:1867–1869.
14.
Commission on Classification and Terminology of the International League Against Epilepsy. Proposal for revised classification of epilepsies and epileptic syndromes. Epilepsia 1989;30:389–399.
15.
Jones DK, Horsfield MA, Simmons A. Optimal strategies for measuring diffusion in anisotropic systems by magnetic resonance imaging. Magn Reson Med 1999;42:515–525.
16.
Mohammadi S, Kugel H, Deppe M. Optimized data preprocessing for group statistics of fractional anisotropy maps. Neuroimage 2007;36(S1):S80.
17.
Le Bihan D, Mangin JF, Poupon C, et al. Diffusion tensor imaging: concepts and applications. J Magn Reson Imaging 2001;13:534–546.
18.
Johansen-Berg H, Behrens TE, Sillery E, et al. Functional-anatomical validation and individual variation of diffusion tractography-based segmentation of the human thalamus. Cereb Cortex 2005;15:31–39.
19.
Blumenfeld H. From molecules to networks: cortical/subcortical interactions in the pathophysiology of idiopathic generalized epilepsy. Epilepsia 2003;44 suppl 2:7–15.
20.
Woermann FG, Free SL, Koepp MJ, Sisodiya SM, Duncan JS. Abnormal cerebral structure in juvenile myoclonic epilepsy demonstrated with voxel-based analysis of MRI. Brain. 1999;122:2101–2108.
21.
Betting LE, Mory SB, Li LM, et al. Voxel-based morphometry in patients with idiopathic generalized epilepsies. Neuroimage 2006;32:498–502.
22.
Tae WS, Hong SB, Joo EY, et al. Structural brain abnormalities in juvenile myoclonic epilepsy patients: volumetry and voxel-based morphometry. Korean J Radiol 2006;7:162–172.
23.
Keller SS, Wilke M, Wieshmann UC, Sluming VA, Roberts N. Comparison of standard and optimized voxel-based morphometry for analysis of brain changes associated with temporal lobe epilepsy. Neuroimage 2004;23:860–868.
24.
Keller SS, Roberts N. Voxel-based morphometry of temporal lobe epilepsy: an introduction and review of the literature. Epilepsia 2008;49:741–757.
25.
Clemens B. Pathological theta oscillations in idiopathic generalised epilepsy. Clin Neurophysiol 2004;115:1436–1441.
26.
Kim JH, Im KC, Kim JS, Lee SA, Kang JK. Correlation of interictal spike-wave with thalamic glucose metabolism in juvenile myoclonic epilepsy. Neuroreport 2005;16:1151–1155.
27.
Behrens TE, Johansen-Berg H, Woolrich MW, et al. Non-invasive mapping of connections between human thalamus and cortex using diffusion imaging. Nat Neurosci 2003;6:750–757.
28.
Koepp MJ. Juvenile myoclonic epilepsy: a generalized epilepsy syndrome? Acta Neurol Scand Suppl 2005;181:57–62.
29.
Devinsky O, Gershengorn J, Brown E, Perrine K, Vazquez B, Luciano D. Frontal functions in juvenile myoclonic epilepsy. Neuropsychiatry Neuropsychol Behav Neurol 1997;10:243–246.
30.
Pung T, Schmitz B. Circadian rhythm and personality profile in juvenile myoclonic epilepsy. Epilepsia 2006;47 suppl 2:111–114.
31.
Trinka E, Kienpointner G, Unterberger I, et al. Psychiatric comorbidity in juvenile myoclonic epilepsy. Epilepsia 2006;47:2086–2091.
32.
Swartz BE, Simpkins F, Halgren E, et al. Visual working memory in primary generalized epilepsy: an 18FDG-PET study. Neurology 1996;47:1203–1212.
33.
Sonmez F, Atakli D, Sari H, Atay T, Arpaci B. Cognitive function in juvenile myoclonic epilepsy. Epilepsy Behav 2004;5:329–336.
34.
Hommet C, Sauerwein HC, De Toffol B, Lassonde M. Idiopathic epileptic syndromes and cognition. Neurosci Biobehav Rev 2006;30:85–96.
35.
Pascalicchio TF, Araujo Filho GM, Silva Noffs MH, et al. Neuropsychological profile of patients with juvenile myoclonic epilepsy: a controlled study of 50 patients. Epilepsy Behav 2007;10:263–267.
36.
Rodriguez A, Whitson J, Granger R. Derivation and analysis of basic computational operations of thalamocortical circuits. J Cogn Neurosci 2004;16:856–877.

Information & Authors

Information

Published In

Neurology®
Volume 71Number 24December 9, 2008
Pages: 1981-1985
PubMed: 19064879

Publication History

Published online: December 8, 2008
Published in print: December 9, 2008

Permissions

Request permissions for this article.

Authors

Affiliations & Disclosures

M. Deppe, PhD
From the Departments of Neurology (M.D., C.K., T.D., G.M., S.M., E.B.R., S.K.) and Clinical Radiology (H.S., H.K.), University of Münster; Department of Neurology (C.K.), Klinikum Osnabrück; Department of Neurology (K.D.), Franzhospital Dülmen, Germany; and The Magnetic Resonance and Image Analysis Research Centre (MARIARC) (S.S.K.), University of Liverpool, UK.
C. Kellinghaus, MD
From the Departments of Neurology (M.D., C.K., T.D., G.M., S.M., E.B.R., S.K.) and Clinical Radiology (H.S., H.K.), University of Münster; Department of Neurology (C.K.), Klinikum Osnabrück; Department of Neurology (K.D.), Franzhospital Dülmen, Germany; and The Magnetic Resonance and Image Analysis Research Centre (MARIARC) (S.S.K.), University of Liverpool, UK.
T. Duning, MD
From the Departments of Neurology (M.D., C.K., T.D., G.M., S.M., E.B.R., S.K.) and Clinical Radiology (H.S., H.K.), University of Münster; Department of Neurology (C.K.), Klinikum Osnabrück; Department of Neurology (K.D.), Franzhospital Dülmen, Germany; and The Magnetic Resonance and Image Analysis Research Centre (MARIARC) (S.S.K.), University of Liverpool, UK.
G. Möddel, MD
From the Departments of Neurology (M.D., C.K., T.D., G.M., S.M., E.B.R., S.K.) and Clinical Radiology (H.S., H.K.), University of Münster; Department of Neurology (C.K.), Klinikum Osnabrück; Department of Neurology (K.D.), Franzhospital Dülmen, Germany; and The Magnetic Resonance and Image Analysis Research Centre (MARIARC) (S.S.K.), University of Liverpool, UK.
S. Mohammadi, MS
From the Departments of Neurology (M.D., C.K., T.D., G.M., S.M., E.B.R., S.K.) and Clinical Radiology (H.S., H.K.), University of Münster; Department of Neurology (C.K.), Klinikum Osnabrück; Department of Neurology (K.D.), Franzhospital Dülmen, Germany; and The Magnetic Resonance and Image Analysis Research Centre (MARIARC) (S.S.K.), University of Liverpool, UK.
K. Deppe, MD
From the Departments of Neurology (M.D., C.K., T.D., G.M., S.M., E.B.R., S.K.) and Clinical Radiology (H.S., H.K.), University of Münster; Department of Neurology (C.K.), Klinikum Osnabrück; Department of Neurology (K.D.), Franzhospital Dülmen, Germany; and The Magnetic Resonance and Image Analysis Research Centre (MARIARC) (S.S.K.), University of Liverpool, UK.
H. Schiffbauer, MD
From the Departments of Neurology (M.D., C.K., T.D., G.M., S.M., E.B.R., S.K.) and Clinical Radiology (H.S., H.K.), University of Münster; Department of Neurology (C.K.), Klinikum Osnabrück; Department of Neurology (K.D.), Franzhospital Dülmen, Germany; and The Magnetic Resonance and Image Analysis Research Centre (MARIARC) (S.S.K.), University of Liverpool, UK.
H. Kugel, PhD
From the Departments of Neurology (M.D., C.K., T.D., G.M., S.M., E.B.R., S.K.) and Clinical Radiology (H.S., H.K.), University of Münster; Department of Neurology (C.K.), Klinikum Osnabrück; Department of Neurology (K.D.), Franzhospital Dülmen, Germany; and The Magnetic Resonance and Image Analysis Research Centre (MARIARC) (S.S.K.), University of Liverpool, UK.
S. S. Keller, PhD
From the Departments of Neurology (M.D., C.K., T.D., G.M., S.M., E.B.R., S.K.) and Clinical Radiology (H.S., H.K.), University of Münster; Department of Neurology (C.K.), Klinikum Osnabrück; Department of Neurology (K.D.), Franzhospital Dülmen, Germany; and The Magnetic Resonance and Image Analysis Research Centre (MARIARC) (S.S.K.), University of Liverpool, UK.
E. B. Ringelstein, MD
From the Departments of Neurology (M.D., C.K., T.D., G.M., S.M., E.B.R., S.K.) and Clinical Radiology (H.S., H.K.), University of Münster; Department of Neurology (C.K.), Klinikum Osnabrück; Department of Neurology (K.D.), Franzhospital Dülmen, Germany; and The Magnetic Resonance and Image Analysis Research Centre (MARIARC) (S.S.K.), University of Liverpool, UK.
S. Knecht, MD
From the Departments of Neurology (M.D., C.K., T.D., G.M., S.M., E.B.R., S.K.) and Clinical Radiology (H.S., H.K.), University of Münster; Department of Neurology (C.K.), Klinikum Osnabrück; Department of Neurology (K.D.), Franzhospital Dülmen, Germany; and The Magnetic Resonance and Image Analysis Research Centre (MARIARC) (S.S.K.), University of Liverpool, UK.

Notes

Address correspondence and reprint requests to Priv.-Doz. Dr. rer. medic. Michael Deppe, Department of Neurology, University of Muenster, Albert-Schweitzer-Str. 33, 48129 Muenster, Germany [email protected]

Metrics & Citations

Metrics

Citations

Download Citations

If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. Select your manager software from the list below and click Download.

Cited By
  1. Structural Connectivity of the Corpus Callosum to Other Cortical Regions, The Corpus Callosum, (101-107), (2023).https://doi.org/10.1007/978-3-031-38114-0_9
    Crossref
  2. Characteristics of Microstructural Changes Associated with Glioma Related Epilepsy: A Diffusion Tensor Imaging (DTI) Study, Brain Sciences, 12, 9, (1169), (2022).https://doi.org/10.3390/brainsci12091169
    Crossref
  3. Felt Stigma and Its Underlying Contributors in Epilepsy Patients, Frontiers in Public Health, 10, (2022).https://doi.org/10.3389/fpubh.2022.879895
    Crossref
  4. Comparison of astrocytes and gap junction proteins in the white matter of genetic absence epileptic and control rats: an experimental study, Neurological Research, 44, 8, (708-718), (2022).https://doi.org/10.1080/01616412.2022.2039527
    Crossref
  5. Understanding frontal lobe function in epilepsy: Juvenile myoclonic epilepsy vs. frontal lobe epilepsy, Epilepsy & Behavior, 134, (108850), (2022).https://doi.org/10.1016/j.yebeh.2022.108850
    Crossref
  6. Structural connectivity of the ANT region based on human ex-vivo and HCP data. Relevance for DBS in ANT for epilepsy, NeuroImage, 262, (119551), (2022).https://doi.org/10.1016/j.neuroimage.2022.119551
    Crossref
  7. Myoclonus and other jerky movement disorders, Clinical Neurophysiology Practice, 7, (285-316), (2022).https://doi.org/10.1016/j.cnp.2022.09.003
    Crossref
  8. Axisymmetric diffusion kurtosis imaging with Rician bias correction: A simulation study, Magnetic Resonance in Medicine, 89, 2, (787-799), (2022).https://doi.org/10.1002/mrm.29474
    Crossref
  9. Abnormalities of Cerebral White Matter Microstructure in Children With New-Onset, Untreated Idiopathic-Generalized Epilepsy, Frontiers in Neurology, 12, (2021).https://doi.org/10.3389/fneur.2021.744723
    Crossref
  10. Identifying juvenile myoclonic epilepsy via diffusion tensor imaging using machine learning analysis, Journal of Clinical Neuroscience, 91, (327-333), (2021).https://doi.org/10.1016/j.jocn.2021.07.035
    Crossref
  11. See more
Loading...

View Options

Get Access

Login options

Check if you have access through your login credentials or your institution to get full access on this article.

Personal login Institutional Login
Purchase Options

Purchase this article to access the full text.

Purchase Access, $39 for 24hr of access

View options

Full Text

View Full Text

Full Text HTML

View Full Text HTML

Media

Figures

Other

Tables

Share

Share

Share article link

Share