Cerebellar white matter changes in patients with newly diagnosed partial epilepsy of unknown etiology.
OBJECTIVE
We hypothesize that pre-existing susceptible structures in the brain may be associated with the development of newly diagnosed partial epilepsy of unknown etiology.


METHODS
Twenty-two patients with newly diagnosed partial epilepsy of unknown etiology and 36 healthy controls were enrolled in this study. In addition, we included 24 patients with chronic partial epilepsy of unknown etiology as a disease control group. We analyzed whole-brain T1-weighted MRIs using FreeSurfer 5.1. The volumes of the hippocampus, amygdala, thalamus, caudate, putamen, pallidum, brainstem, cerebellar gray and white matter, as well as cerebral gray and white matter were compared between the groups. We also analyzed the changes in brain volumes associated with the chronicity of epilepsy in the patients with chronic epilepsy compared to newly diagnosed epilepsy.


RESULTS
The volume of cerebellar white matter in patients with newly diagnosed epilepsy was significantly smaller than that which was observed in the healthy controls (p=0.0001). This finding was also observed in patients with chronic epilepsy (p<0.0001). Cerebral white matter volume was negatively correlated with the duration of epilepsy (r=-0.4, p=0.04).


CONCLUSIONS
These findings support our hypothesis that cerebellar white matter changes may constitute a pre-existing susceptible structure in the brain that is associated with the development of partial epilepsy of unknown etiology. In addition, cerebral white matter was the structure that was the most vulnerable to the progression of epilepsy.
Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, South Korea.
Kang Min
KM
Park
Department of Biomedical Engineering/u-HARC, Inje University, Gimhae, South Korea.
Yong Hee
YH
Han
Department of Health Science and Technology, Inje University, Gimhae, South Korea.
Tae Hyung
TH
Kim
Department of Biomedical Engineering/u-HARC, Inje University, Gimhae, South Korea; Department of Health Science and Technology, Inje University, Gimhae, South Korea.
Chi Woong
CW
Mun
Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, South Korea.
Kyong Jin
KJ
Shin
Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, South Korea.
Sam Yeol
SY
Ha
Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, South Korea.
JinSe
J
Park
Department of Pediatrics, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea, Haeundae Paik Hospital, Inje University College of Medicine, Busan, South Korea.
Yun Jung
YJ
Hur
Department of Neurosurgery, Haeundae Paik Hospital, Inje University College of Medicine, Busan, South Korea.
Hae Yu
HY
Kim
Department of Internal Medicine, Haeundae Paik Hospital, Inje University College of Medicine, Busan, South Korea.
Si Hyung
SH
Park
Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, South Korea. Electronic address: epidoc@inje.ac.kr.
Sung Eun
SE
Kim
D000328:Adult; D017668:Age of Onset; D001284:Atrophy / Q000473:pathology; D002531:Cerebellum / Q000473:pathology*; D003430:Cross-Sectional Studies; D004828:Epilepsies, Partial / Q000209:etiology / Q000473:pathology*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D013788:Thalamus / Q000473:pathology; D066127:White Matter / Q000473:pathology*
Atrophy; Cerebellum; Epilepsy