Department of Clinical Neuroscience, Institute of Psychiatry, King's College London, De Crespigny Park, London SE5 8AF, UK.
Neurology. 2011 Jan 4;76(1):34-40. doi: 10.1212/WNL.0b013e318203e93d.
The aim of this study was to determine if there were focal cortical abnormalities in juvenile myoclonic epilepsy (JME) using neuropsychological investigations and MRI.
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.
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.
The neuropsychological, structural, and tractography results implicate mesial frontal cortex, especially the supplementary motor area, and posterior cingulate cortex in JME.
本研究旨在通过神经心理学研究和 MRI 来确定青少年肌阵挛癫痫（JME）是否存在皮质异常。
使用一系列神经心理学测试以及结构和扩散张量 MRI（DTI）对 28 名 JME 患者和大量健康对照组进行评估。DTI 测量评估了白质骨架内的各向异性分数（FA）。
神经心理学测试表明，言语流畅性、理解和表达以及非言语记忆和思维灵活性方面存在轻微的功能障碍。利用全脑基于体素的形态学分析进行灰质 MRI 数据和基于束的空间统计学进行白质扩散 MRI 数据，我们发现补充运动区和后扣带回的灰质体积（GMV）减少，胼胝体下的白质 FA 减少。补充运动区的 FA 预测了单词命名任务的得分和表达得分。后扣带回 GMV 和 FA 预测了心理灵活性任务中的认知抑制得分。
神经心理学、结构和轨迹结果表明 JME 中存在额内侧皮层，特别是补充运动区和后扣带回。
