Zhang Jun, Wu Dan, Yang Haoran, Lu Hongjuan, Ji Yichen, Liu Huixin, Zang Zhenxiang, Lu Jie, Sun Wei
Department of Neurology, Xuanwu Hospital Capital Medical University, Beijing, China.
Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China.
Front Neurol. 2022 May 16;13:883078. doi: 10.3389/fneur.2022.883078. eCollection 2022.
To explore the structural brain abnormality and its relationship with neuropsychological disorders and electroclinical characteristics in juvenile myoclonic epilepsy (JME) patients.
Sixty-seven patients diagnosed with JME and 56 healthy controls were enrolled. All subjects underwent MRI using T1-weighted 3D brain structural images with 1 mm thickness. Voxel-based morphometry (VBM) and surface-based morphometry (SBM) analyses were performed. They also underwent a series of neuropsychological tests to assess cognitive function. The correlation analyses were conducted between structural changes, neuropsychological outcomes, and electroclinical features.
The gray matter concentration (GMC) was decreased in the bilateral pre-central and post-central gyrus, right anterior cingulate gyrus, left posterior orbital region, bilateral occipital regions, bilateral hippocampus and bilateral caudate nucleus in the JME groups (corrected < 0.05). The evaluation of gray matter volume (GMV) showed significant decrease respectively in bilateral pre-central and post-central gyrus, left paracentral lobule, left orbital gyrus, left amygdala, left basal ganglia and left thalamus of JME patients ( < 0.05). The cortex thicknesses of the right inferior temporal gyrus, right insular gyrus, and right cingulate gyrus had negative correlations with the disease duration significantly. At the same time, the whole-brain white matter volume was positively associated with the course of the disease ( < 0.05). Patients with persistent abnormal EEG discharges had significantly less whole-brain gray matter volume than JME patients with normal EEG ( = 0.03). Correlation analyses and linear regression analyses showed that, in addition to the gray matter volumes of frontal and parietal lobe, the temporal lobe, as well as the basal ganglia and thalamus, were also significantly correlated with neuropsychological tests' results ( < 0.05).
The JME patients showed subtle structural abnormalities in multiple brain regions that were not only limited to the frontal lobe but also included the thalamus, basal ganglia, parietal lobe, temporal lobe and some occipital cortex, with significant involvement of the primary somatosensory cortex and primary motor cortex. And we significantly demonstrated a correlation between structural abnormalities and cognitive impairment. In addition, the course of disease and abnormal discharges had a specific negative correlation with the structural changes.
探讨青少年肌阵挛癫痫（JME）患者脑结构异常及其与神经心理障碍和电临床特征的关系。
纳入67例诊断为JME的患者和56例健康对照。所有受试者均采用层厚1mm的T1加权3D脑结构图像进行MRI检查。进行基于体素的形态学测量（VBM）和基于表面的形态学测量（SBM）分析。他们还接受了一系列神经心理测试以评估认知功能。对结构变化、神经心理结果和电临床特征进行相关性分析。
JME组双侧中央前回和中央后回、右侧前扣带回、左侧眶后区、双侧枕叶、双侧海马和双侧尾状核的灰质浓度（GMC）降低（校正后P<0.05）。灰质体积（GMV）评估显示，JME患者双侧中央前回和中央后回、左侧中央旁小叶、左侧眶回、左侧杏仁核、左侧基底节和左侧丘脑的GMV分别显著降低（P<0.05）。右侧颞下回、右侧岛叶和右侧扣带回的皮质厚度与病程呈显著负相关。同时，全脑白质体积与病程呈正相关（P<0.05）。脑电图持续异常放电的患者全脑灰质体积显著低于脑电图正常的JME患者（P=0.03）。相关性分析和线性回归分析表明，除额叶和顶叶的灰质体积外，颞叶以及基底节和丘脑也与神经心理测试结果显著相关（P<0.05）。
JME患者在多个脑区存在细微的结构异常，不仅限于额叶，还包括丘脑、基底节、顶叶、颞叶和部分枕叶皮质，初级躯体感觉皮质和初级运动皮质受累明显。我们显著证明了结构异常与认知障碍之间的相关性。此外，病程和异常放电与结构变化存在特定的负相关。
