title: Investigation of the cingulate cortex in idiopathic generalized epilepsy.
abstract: OBJECTIVE
  Studies using quantitative neuroimaging have shown subtle abnormalities in patients with idiopathic generalized epilepsy (IGE). These findings have several locations, but the midline parasagittal structures are most commonly implicated. The cingulate cortex is related and may be involved. The objective of the current investigation was to perform a comprehensive analysis of the cingulate cortex using multiple quantitative structural neuroimaging techniques.
  
  
  METHODS
  Thirty-two patients (18 women, 30 ± 10 years) and 36 controls (18 women, 32 ± 11 years) were imaged by 3 Tesla magnetic resonance imaging (MRI). A volumetric three-dimensional (3D) sequence was acquired and used for this investigation. Regions-of-interest were selected and voxel-based morphometry (VBM) analyses compared the cingulate cortex of the two groups using Statistical Parametric Mapping (SPM8) and VBM8 software. Cortical analyses of the cingulate gyrus was performed using Freesurfer. Images were submitted to automatic processing using built-in routines and recommendations. Structural parameters were extracted for individual analyses, and comparisons between groups were restricted to the cingulate gyrus. Finally, shape analyses was performed on the anterior rostral, anterior caudal, posterior, and isthmus cingulate using spherical harmonic description (SPHARM).
  
  
  RESULTS
  VBM analyses of cingulate gyrus showed areas of gray matter atrophy, mainly in the anterior cingulate gyrus (972 mm(3) ) and the isthmus (168 mm(3) ). Individual analyses of the cingulate cortex were similar between patients with IGE and controls. Surface-based comparisons revealed abnormalities located mainly in the posterior cingulate cortex (718.12 mm(2) ). Shape analyses demonstrated a predominance of anterior and posterior cingulate abnormalities.
  
  
  CONCLUSIONS
  This study suggests that patients with IGE have structural abnormalities in the cingulate gyrus mainly localized at the anterior and posterior portions. This finding is subtle and variable among patients.
authors.affiliation: Department of Neurology, Psychology and Psychiatry, Botucatu Medical School, São Paulo State University, UNESP, Botucatu, SP, Brazil.
authors.forename: Aline M da S
authors.initials: AM
authors.lastname: Braga
authors.affiliation: Department of Neurology, Psychology and Psychiatry, Botucatu Medical School, São Paulo State University, UNESP, Botucatu, SP, Brazil.
authors.forename: Elaine K
authors.initials: EK
authors.lastname: Fujisao
authors.affiliation: Department of Neurology, Psychology and Psychiatry, Botucatu Medical School, São Paulo State University, UNESP, Botucatu, SP, Brazil.
authors.forename: Roberto C
authors.initials: RC
authors.lastname: Verdade
authors.affiliation: Department of Neurology, Psychology and Psychiatry, Botucatu Medical School, São Paulo State University, UNESP, Botucatu, SP, Brazil.
authors.forename: Rômulo P
authors.initials: RP
authors.lastname: Paschoalato
authors.affiliation: Department of Neurology, Psychology and Psychiatry, Botucatu Medical School, São Paulo State University, UNESP, Botucatu, SP, Brazil.
authors.forename: Ricardo P
authors.initials: RP
authors.lastname: Paschoalato
authors.affiliation: Department of Tropical Diseases and Diagnostic Imaging, Botucatu Medical School, São Paulo State University, UNESP, Botucatu, SP, Brazil.
authors.forename: Seizo
authors.initials: S
authors.lastname: Yamashita
authors.affiliation: Department of Neurology, Psychology and Psychiatry, Botucatu Medical School, São Paulo State University, UNESP, Botucatu, SP, Brazil.
authors.forename: Luiz E
authors.initials: LE
authors.lastname: Betting
mesh_terms: D000293:Adolescent; D000328:Adult; D001931:Brain Mapping / Q000379:methods*; D004829:Epilepsy, Generalized / Q000175:diagnosis* / Q000378:metabolism*; D005260:Female; D006179:Gyrus Cinguli / Q000378:metabolism* / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D055815:Young Adult
keywords: Cingulate cortex; Idiopathic generalized epilepsy; Neuroimaging; Shape analysis; Voxel-based morphometry