Distribution of Cerebral Gray and White Matters in Juvenile Myoclonic Epilepsy: Voxel Based Morphometry

Tae, Woo Suk; Joo, Eun Yeon; Hong, Seung Bong

Abstract

BACKGROUND
The brain MRI findings of juvenile myoclonic epilepsy (JME) usually appears normal upon visual inspection. The purpose of this study is to analyze the distributions of gray matter (GM) and white matter (WM) features with voxel based morphometry (VBM). METHODS: Nineteen JME patients and 19 age and sex matched normal subjects underwent a volumetric MRI study. The MRIs were spatially normalized to our T1 template and segmented into GM, WM and CSF. The spatially normalized and segmented images were smoothed. The smoothed images of GM and WM were analyzed with t-tests. Statistical nonparametric mapping (SnPM) was also used without the assumption of normality. RESULTS: At the level of uncorrected p<0.05, there were brain regions with significantly decreased or increased GM and WM distributions in JME patients compared to those of the normal controls. GM decreased in the left dorsolateral-prefrontal lobe (p=0.005), both medial prefrontal lobes (p=0.01), both medial orbito-frontal lobes (p=0.005), and left middle inferior temporal gyrus (p=0.005) while GM increased in both putamina (right: p=0.005, left: p=0.01), right caudate nucleus (p=0.005), right antero-superior temporal gyrus (p=0.005), both medial parietal lobes (p=0.005), and both medial occipital lobes (p=0.005). WM decreased in the right internal capsule (p=0.005), left internal capsule (p=0.05), and left temporal stem (p=0.05) whereas WM increased in the right temporal stem (p=0.05) and both occipital areas (p=0.001). CONCLUSIONS: JME patients appear to have abnormal distributions of GM and WM in their brains. However, it is not determined whether this finding is an ontogenical abnormality or seizure related problem.