title: Subcortical structural abnormalities in juvenile myoclonic epilepsy (JME): MR volumetry and vertex based analysis.
abstract: OBJECTIVE
  Imaging studies in juvenile myoclonic epilepsy (JME) have shown abnormalities of the thalamus and frontal cortex. The purpose of this study was to systematically investigate the morphological changes in the deep gray matter (GM) structures using techniques of voxel based morphometry (VBM), MR volumetry and shape analysis.
  
  
  METHODS
  The study included 40 patients with JME (M:F=21:19; age 22.8±5.3 years) and 19 matched controls (M:F=13:6; age 24.5±4.2 years). All subjects underwent MRI using standard protocol that included T1-3D TFE (Turbo Field Echo) images with 1mm thickness. VBM analysis and MR volumetry were performed. The volumes of deep subcortical GM structures were extracted and vertex-wise shape analysis was performed using FSL-FIRST (FSL-Integrated Registration and Segmentation Toolbox) software.
  
  
  RESULTS
  VBM analysis with a thalamic mask revealed focal thalamic alterations in the anteromedial aspect of the thalamus (p<0.05, false discovery rate (FDR) corrected) which remained significant after adjusting for age, gender and intracranial volume (ICV). Significant volume loss was noted in both the thalami. Vertex-wise shape analysis showed significant focal surface reductions in the thalami bilaterally in patients that were predominantly seen in the medial as well as lateral aspects of the thalamus (p<0.05, FDR corrected). The disease duration correlated with left hippocampus volume while age of onset correlated with right hippocampus volume.
  
  
  CONCLUSIONS
  This study confirms the presence of thalamic alterations in patients with JME. Shape analysis technique provided complementary information and disclosed the presence of focal atrophic changes in patients' thalami. The striatum and hippocampus did not show any significant alterations.
authors: Department of Neuroimaging and Interventional Radiology, NIMHANS, Bangalore, India.
authors: J
authors: J
authors: Saini
authors: S
authors: S
authors: Sinha
authors: B S
authors: BS
authors: Bagepally
authors: C T
authors: CT
authors: Ramchandraiah
authors: K
authors: K
authors: Thennarasu
authors: C
authors: C
authors: Prasad
authors: A B
authors: AB
authors: Taly
authors: P
authors: P
authors: Satishchandra
mesh_terms: D000293:Adolescent; D000328:Adult; D000679:Amygdala / Q000473:pathology; D001284:Atrophy / Q000473:pathology; D003342:Corpus Striatum / Q000473:pathology; D005260:Female; D006624:Hippocampus / Q000473:pathology*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D020190:Myoclonic Epilepsy, Juvenile / Q000473:pathology*; D036421:Nerve Fibers, Unmyelinated / Q000473:pathology*; D009929:Organ Size; D013788:Thalamus / Q000473:pathology*