Lee Dong Ah, Lee Ho-Joon, Park Kang Min
Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, South Korea.
Department of Radiology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, South Korea.
Seizure. 2025 Jan;124:75-79. doi: 10.1016/j.seizure.2024.12.003. Epub 2024 Dec 4.
Peak width of skeletonized mean diffusivity (PSMD) is a novel marker of white matter changes probably due to small vessel disease. This study aimed to investigate the presence of white matter changes in juvenile myoclonic epilepsy (JME) using PSMD.
We enrolled patients with JME and age- and sex-matched healthy controls. We performed diffusion tensor imaging (DTI) using a three tesla magnetic resonance imaging scanner. We measured the PSMD based on DTI in several steps, including preprocessing, skeletonization, application of a custom mask, and histogram analysis, using the FSL program. We compared the PSMD between patients with JME and healthy controls and the PSMD according to the antiseizure medication (ASM) response among the patients with JME. We also performed a correlation analysis between the PSMD and clinical factors in patients with JME.
We enrolled the 42 patients with newly diagnosed JME and 42 healthy controls. There was a significant difference in the PSMD between patients with JME and healthy controls. PSMD was higher in patients with JME than in healthy controls (2.234 vs. 2.085 × 10 mm/s, p = 0.013). In addition, the PSMD was higher in patients with JME who were ASM poor responders than in those who were ASM good responders (2.586 vs. 2.176 × 10 mm/s, p = 0.007). The PSMD was positively correlated with age (r = 0.364, p = 0.017).
Patients with JME have a higher PSMD than healthy controls, indicating evidence of white matter changes in patients with JME. In addition, white matter changes are related to the ASM response in patients with JME. This finding also highlights the potential of PSMD as a marker for detecting white matter changes probably due to small vessel disease in patients with epilepsy, which would require further studies.
骨骼化平均扩散率的峰值宽度（PSMD）是一种可能由小血管疾病导致的白质变化的新型标志物。本研究旨在使用PSMD来调查青少年肌阵挛性癫痫（JME）患者中白质变化的存在情况。
我们纳入了JME患者以及年龄和性别匹配的健康对照者。使用3特斯拉磁共振成像扫描仪进行扩散张量成像（DTI）。我们基于DTI通过几个步骤测量PSMD，包括预处理、骨骼化、应用自定义掩码以及使用FSL程序进行直方图分析。我们比较了JME患者与健康对照者之间的PSMD，以及JME患者中根据抗癫痫药物（ASM）反应的PSMD。我们还对JME患者的PSMD与临床因素进行了相关性分析。
我们纳入了42例新诊断的JME患者和42名健康对照者。JME患者与健康对照者之间的PSMD存在显著差异。JME患者的PSMD高于健康对照者（2.234对2.085×10毫米/秒，p = 0.013）。此外，ASM反应不佳的JME患者的PSMD高于ASM反应良好的患者（2.586对2.176×10毫米/秒，p = 0.007）。PSMD与年龄呈正相关（r = 0.364，p = 0.017）。
JME患者的PSMD高于健康对照者，表明JME患者存在白质变化的证据。此外，白质变化与JME患者的ASM反应有关。这一发现还凸显了PSMD作为检测癫痫患者中可能由小血管疾病导致的白质变化标志物的潜力，这需要进一步研究。
