Korean J Radiol.  2006 Sep;7(3):162-172. 10.3348/kjr.2006.7.3.162.

Structural Brain Abnormalities in Juvenile Myoclonic Epilepsy Patients: Volumetry and Voxel-Based Morphometry

• Tae WS
• Hong SB
• Joo EY
• Han SJ
• Cho JW
• Seo DW
• Lee JM
• Kim IY
• Byun HS
• Kim SI

• KMID: 1114348
• DOI: http://doi.org/10.3348/kjr.2006.7.3.162

Abstract

OBJECTIVE
We aimed to find structural brain abnormalities in juvenile myoclonic epilepsy (JME) patients. MATERIALS AND METHODS: The volumes of the cerebrum, hippocampus and frontal lobe and the area of the corpus callosum's subdivisions were all semi-automatically measured, and then optimized voxel-based morphometry (VBM) was performed in 19 JME patients and 19 age/gender matched normal controls. RESULTS: The rostrum and rostral body of the corpus callosum and the left hippocampus were significantly smaller than those of the normal controls, whereas the volume of the JME's left frontal lobe was significantly larger than that of the controls. The area of the rostral body had a significant positive correlation with the age of seizure onset (r = 0.56, p = 0.012), and the volume of the right frontal lobe had a significant negative correlation with the duration of disease (r = -0.51, p = 0.025). On the VBM, the gray matter concentration of the prefrontal lobe (bilateral gyri rectus, anterior orbital gyri, left anterior middle frontal gyrus and right anterior superior frontal gyrus) was decreased in the JME group (corrected p < 0.05). CONCLUSION: The JME patients showed complex structural abnormalities in the corpus callosum, frontal lobe and hippocampus, and also a decreased gray matter concentration of the prefrontal region, which all suggests there is an abnormal neural network in the JME brain.

Keyword

Magnetic resonance (MR), image processing; Juvenile myoclonic epilepsy; Hippocampus; Corpus callosum; Frontal lobe

MeSH Terms

*Signal Processing, Computer-Assisted
Organ Size
Myoclonic Epilepsy, Juvenile/*pathology
Male
Magnetic Resonance Imaging/*methods
Imaging, Three-Dimensional/*methods
Image Interpretation, Computer-Assisted/*methods
Humans
Female
Brain/*pathology
Adult

Figure

• 

  Fig. 1 Region of interest definition and area measurement of the corpus callosum. To get an exact midsaggital image, the SPGR MRI is translated by one voxel. A. The midsagittal schematic diagram of the corpus callosum shows the determination of the seven subregions. B. The corpus callosal boundary is manually traced and dividing lines, according to the Witelson's criteria, are automatically placed. The region of interest lines are redrawn for the presentation.

• 

  Fig. 2 Anatomical boundary of the hippocampus. To outline the hippocampus from the amyglada, the head of the hippocampus (white dotted arrow) is separated from the amygdala (white solid arrow) by the alveus and the three dimensional position marking. Once the probable boundary of the hippocampus is manually pointed to on the coronal image (A, white cross mark), the same position is automatically marked on the sagittal image (B). With the combination of the anatomic landmarks (alveus, black arrow) and the pixel position marking, the head of the hippocampus could be easily separated from the amygdala. The boundary of hippocampus head (C-2, D-2, E-2) is traced from the original images (C-1, D-1, E-1).

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  Fig. 3 The measurement of the frontal lobe volume on the axial MRI. From the segmented cerebrum, the central sulcus is identified with the hand knob (solid arrow) in the precentral gyrus. The posterior margin of the frontal lobe is delineated by the central sulcus.

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  Fig. 4 Correlation of the rostral body area of the corpus callosum and the frontal lobe volume with the clinical variables of the juvenile myoclonic epilepsy patients. A. The normalized area of the rostral body of the corpus callosum is positively correlated with the age of epilepsy onset. B. The normalized volume of the right frontal lobe is negatively correlated with the duration of disease.

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  Fig. 5 Voxel-based morphometry. The gray matter concentration was decreased in the bilateral gyri rectus (solid arrow), and the anterior orbital gyri (dotted arrow) in the juvenile myoclonic epilepsy patients compared to the normal controls (false discovery rate corrected p < 0.05).

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