Subcortical nuclei volumetry in idiopathic generalized epilepsy.
OBJECTIVE
The exact anatomic and neurophysiologic correlates of idiopathic generalized epilepsy (IGE) in humans are still not well understood, although the thalamus has frequently been invoked as the crucial structure in the generation of primary generalized seizures. The few in vivo magnetic resonance (MR)-based studies in IGE patients suggest an altered cortical/subcortical gray matter ratio, but with no evidence of structural alterations of the thalamus. In this study, we sought to determine the volumes of the other subcortical structures.


METHODS
The volumes of the caudate nucleus, putamen, pallidum as well as the thalamus were each determined in both hemispheres in 11 patients with various IGE syndromes, normalized for whole-brain volumes and then compared with 15 age-matched controls.


RESULTS
No differences were noted in thalamic volumes, confirming previous reports. However, smaller subcortical volumes were noted in the IGE patients (p < 0.009), mainly due to smaller putamen bilaterally (p < or = 0.015).


CONCLUSIONS
It is speculated that the presence of discrete frontal dysfunction, as noted in neuropsychological studies in IGE patients, indirectly supports our results because the putamen projects predominantly to the frontal cortex. Larger studies with more homogeneous patient populations are needed to determine the robustness of these findings and whether they are specific for particular IGE syndromes.
Seeck
Margitta
M
Presurgical Epilepsy Evaluation Unit, Functional Neurology and Neurosurgery Program of the University Hospitals Lausanne and Geneva, Switzerland. margitta.seeck@hcuge.ch
Dreifuss
Sylvain
S
Lantz
Goran
G
Jallon
Pierre
P
Foletti
Giovanni
G
Despland
Paul-Andre
PA
Delavelle
Jacqueline
J
Lazeyras
Francois
F
D000328:Adult; D001284:Atrophy / Q000473:pathology; D001921:Brain / Q000473:pathology*; D002421:Caudate Nucleus / Q000473:pathology; D002467:Cell Nucleus / Q000473:pathology*; D048429:Cell Size; D004829:Epilepsy, Generalized / Q000473:pathology* / Q000503:physiopathology; D005260:Female; D005625:Frontal Lobe / Q000503:physiopathology; D005917:Globus Pallidus / Q000473:pathology; D006801:Humans; D007620:Karyometry / Q000379:methods; D008297:Male; D009474:Neurons / Q000473:pathology*; D011699:Putamen / Q000473:pathology; D013788:Thalamus / Q000473:pathology