Third Department of Neurology, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece.
Department of Neurology, Leeds Teaching Hospitals, NHS Trust, Leeds LS2 9JT, UK.
Medicina (Kaunas). 2021 Oct 20;57(11):1136. doi: 10.3390/medicina57111136.
. Juvenile myoclonic epilepsy (JME) is an idiopathic generalized epileptic syndrome, with a genetic basis clinically identified by myoclonic jerks of the upper limbs upon awaking, generalized tonic-clonic seizures and less frequent absences. Although the brain magnetic resonance imaging (MRI) is by definition normal, computer-based Voxel-Based morphometry studies have shown a number of volumetric changes in patients with juvenile myoclonic epilepsy. Thus, the aim of the present Voxel-Wise Meta-Analysis was to determine the most consistent regional differences of gray matter volume between JME patients and healthy controls. The initial search returned 31 studies. After excluding reviews and studies without control groups or without detailed peak coordinates, 12 studies were finally included in the present meta-analysis. The total number of JME patients was 325, and that of healthy controls was 357. Our study showed a statistically significant increase of the gray matter in the left median cingulate/paracingulate gyri, the right superior frontal gyrus, the left precentral gyrus, the right supplementary motor area and left supplementary motor area. It also showed a decrease in the gray matter volume in the left thalamus, and in the left insula. Our findings could be related to the functional deficits and changes described by previous studies in juvenile myoclonic epilepsy. In this way, the volumetric changes found in the present study could be related to the impaired frontal lobe functions, the emotional dysfunction and impaired pain empathy, and to the disrupted functional connectivity of supplementary motor areas described in JME. It additionally shows changes in the volume of the left thalamus, supporting the theory of thalamocortical pathways being involved in the pathogenesis of juvenile myoclonic epilepsy.
. 青少年肌阵挛癫痫（JME）是一种特发性全面性癫痫综合征，具有遗传基础，临床上表现为上肢肌阵挛性觉醒、全面性强直阵挛发作和较少见的失神发作。尽管脑磁共振成像（MRI）定义上正常，但基于计算机的体素形态计量学研究表明，青少年肌阵挛癫痫患者存在许多体积变化。因此，本 Voxel-Wise 荟萃分析的目的是确定 JME 患者与健康对照组之间灰质体积最一致的区域差异。最初的搜索返回了 31 项研究。排除综述和没有对照组或没有详细峰值坐标的研究后，最终有 12 项研究纳入本荟萃分析。JME 患者的总人数为 325 人，健康对照组的人数为 357 人。我们的研究显示，左中央扣带回/旁扣带回、右额上回、左中央前回、右辅助运动区和左辅助运动区的灰质体积存在统计学上显著增加。还显示左丘脑和左岛叶灰质体积减少。我们的发现可能与以前研究中描述的青少年肌阵挛癫痫的功能缺陷和变化有关。这样，本研究中发现的体积变化可能与额叶功能受损、情绪功能障碍和疼痛共情受损以及 JME 中描述的辅助运动区功能连接中断有关。此外，还显示左丘脑体积变化，支持丘脑皮质通路参与青少年肌阵挛癫痫发病机制的理论。
