title: Thalamofrontal circuitry and executive dysfunction in recent-onset juvenile myoclonic epilepsy.
abstract: OBJECTIVE
  Thalamofrontal abnormalities have been identified in chronic primary generalized epilepsy, specifically in juvenile myoclonic epilepsy (JME). These regions also underlie executive functioning, although their relationship has yet to be examined in JME. This study examined the relationship between thalamic and frontal volumes and executive function in recent-onset JME compared to healthy control subjects and recent-onset benign childhood epilepsy with centrotemporal spikes (BCECTS), a syndrome not typically associated with thalamocortical or executive dysfunction.
  
  
  METHODS
  Twenty children with recent-onset JME were compared to 51 healthy controls and 12 children with BCECTS using quantitative magnetic resonance imaging (MRI) and measures of executive abilities. Quantitative thalamic and frontal volumes were obtained through semi-automated software. Subtests from the Delis-Kaplan Executive Function System (D-KEFS) and the Behavior Rating Inventory of Executive Function (BRIEF) were used to measure executive function.
  
  
  RESULTS
  Executive functions were impaired in JME subjects compared to control and BCECTS subjects. Subjects with JME had significantly smaller thalamic volumes and more frontal cerebrospinal fluid (CSF) than control and BCECTS subjects. Thalamic and frontal volumes were significantly related to executive functioning in the JME group, but not in the other two groups.
  
  
  CONCLUSIONS
  Children with JME have significant executive dysfunction associated with significantly smaller thalami and more frontal CSF. Children with recent-onset BCECTS do not display the same pattern. Frontal and thalamic volumes appear to mediate the relationship between executive functioning and brain structure in JME.
authors.affiliation: Department of Psychology, Rosalind Franklin University of Medicine and Science, North Chicago, Illinois 60064, USA. dalin.pulsipher@my.rfums.org
authors.forename: Dalin T
authors.initials: DT
authors.lastname: Pulsipher
authors.forename: Michael
authors.initials: M
authors.lastname: Seidenberg
authors.forename: Leslie
authors.initials: L
authors.lastname: Guidotti
authors.forename: Victoria N
authors.initials: VN
authors.lastname: Tuchscherer
authors.forename: Jared
authors.initials: J
authors.lastname: Morton
authors.forename: Raj D
authors.initials: RD
authors.lastname: Sheth
authors.forename: Bruce
authors.initials: B
authors.lastname: Hermann
mesh_terms: D000293:Adolescent; D002648:Child; D003072:Cognition Disorders / Q000209:etiology*; D005260:Female; D005625:Frontal Lobe / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D015999:Multivariate Analysis; D020190:Myoclonic Epilepsy, Juvenile / Q000150:complications* / Q000473:pathology*; D009434:Neural Pathways / Q000473:pathology; D009483:Neuropsychological Tests; D011340:Problem Solving / Q000502:physiology*; D012044:Regression Analysis; D013788:Thalamus / Q000473:pathology*