Microstructural and volumetric abnormalities of the putamen in juvenile myoclonic epilepsy
Microstructural and volumetric abnormalities of the putamen in juvenile myoclonic epilepsy
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DOI：
10.1111/j.1528-1167.2011.03117.x
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发表时间：
2011-09-01
期刊：
影响因子：
5.6
通讯作者：
Deppe, Michael
中科院分区：
文献类型：
--
作者：
Keller, Simon S.;Ahrens, Tobias;Deppe, Michael
目的：青少年肌阵挛性癫痫（JME）患者表现出丘脑皮质纤维束微结构白色物质（WM）损伤和纹状体-丘脑皮质网络血氧水平依赖（BOLD）信号改变的证据。本研究的目的是探讨微结构和体积的变化，在JME患者使用扩散张量成像（DTI）和常规磁共振成像（MRI）。方法：我们进行了DTI和MRI的10例JME患者和59名年龄匹配的神经健康志愿者。微结构损伤的评价进行了研究，使用计算平均分数各向异性（FA）值在一个先验区域的利益（ROI）的壳核，额叶，丘脑皮质区，应用改进的涡流校正方法和一个新的统计参数映射（SPM）兼容的工具箱，将密集的多对比FA图像配准后。对MRI进行体视学分析，以估计所有受试者大脑两半球壳核的宏观体积。关键发现：相对于对照组，患者额叶FA（p = 0.01）和丘脑皮质纤维WM（p < 0.001）显著降低。相比之下，仅患者的壳核FA双侧增加（p = 0.01），并与壳核体积减少相关（r（2）=-0.63，p = 0.004）。壳核FA与JME的发病呈负相关（总：r（2）=-0.50，p = 0.01）、JME持续时间（r（2）= 0.52，p = 0.01）和丘脑皮质纤维FA（r（2）=-0.47，p = 0.01）。这是第一个在JME患者中合并微结构和宏观结构壳核异常的证据，发病年龄早和癫痫持续时间长是更大的结构改变的重要预测因素。这些结果是一致的研究表明，额纹状体网络的神经生理异常与JME患者，并可能有助于解释频繁出现的执行功能障碍，在这些患者。需要在更大的样本中确认和进一步探索JME患者壳核FA的增加。
Purpose: Patients with juvenile myoclonic epilepsy (JME) show evidence of microstructural white matter (WM) damage of thalamocortical fiber tracts and changes of blood oxygen level dependent (BOLD) signal in a striato-thalamocortical network. The objective of the present study was to investigate microstructural and volumetric alterations of the putamen in patients with JME using diffusion tensor imaging (DTI) and conventional magnetic resonance imaging (MRI).Methods: We performed DTI and MRI for 10 patients with JME and 59 age-matched neurologically healthy volunteers. Evaluation of microstructural damage was investigated using calculation of mean fractional anisotropy (FA) values in a priori regions of interest (ROIs) for the putamen, frontal lobe, and a thalamocortical region, after application of an improved eddy current correction method and a new statistical parametric mapping (SPM)-compatible toolbox incorporating intensive multicontrast FA image registration. Stereologic analysis on MRI was performed to estimate macroscopic volume of the putamen in both cerebral hemispheres for all subjects.Key Findings: Relative to controls, patients had significantly reduced FA in the frontal lobe (p = 0.01) and thalamocortical fiber WM (p < 0.001). In contrast, putamen FA was bilaterally increased (p = 0.01) and correlated with decreasing putamen volume (r(2) = -0.63, p = 0.004) in patients only. Putamen FA correlated negatively with onset of JME (total: r(2) = -0.50, p = 0.01), duration of JME (r(2) = 0.52, p = 0.01), and thalamocortical fiber FA (r(2) = -0.47, p = 0.01).Significance: This is the first evidence of combined microstructural and macrostructural putamen abnormalities in patients with JME, with early age of onset and a longer duration of epilepsy being significant predictors for greater architectural alterations. These findings are consistent with studies indicating neurophysiologic abnormalities of frontostriatal networks in patients with JME, and may contribute to explain the frequent presentation of executive dysfunction in these patients. Confirmation and further exploration of the increase in putamen FA in patients with JME is required in larger samples.