title: Proton magnetic resonance spectroscopy in juvenile myoclonic epilepsy: A systematic review and meta-analysis.
abstract: OBJECTIVE
  We sought to systematically review and perform a meta-analysis of the magnetic resonance spectroscopy (MRS) findings regarding juvenile myoclonic epilepsy (JME).
  
  
  METHODS
  We searched for studies in the PubMed, Web of Science, and Embase electronic databases. Two authors collected articles and extracted data independently. A meta-analysis was performed for diverse metabolites in different brain areas. The mean difference (MD) and 95% confidence interval (CI) were used to compare continuous variables.
  
  
  RESULTS
  A decreased NAA/Cr was observed in the motor cortex (MD=0.14, 95%CI=0.09 to 0.20), and the NAA was reduced in the thalamus (MD=0.74, 95%CI=0.37 to 1.10) and the frontal lobe (MD=0.87, 95%CI=0.45 to 1.28); the GLX/Cr was increased in the insula (MD=-0.10, 95%CI=-0.14 to -0.06) and the striatum (MD=-0.11, 95%CI=-0.17 to -0.05).
  
  
  CONCLUSIONS
  JME may be a multi-regional, thalamo-frontal network epilepsy rather than an idiopathic generalized epilepsy syndrome.
authors.affiliation: Department of Neurology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China.
authors.forename: Lin
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Department of Neurology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China.
authors.forename: Hua
authors.initials: H
authors.lastname: Li
authors.affiliation: Department of Neurology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China.
authors.forename: Peiwei
authors.initials: P
authors.lastname: Hong
authors.affiliation: Department of Neurology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China. Electronic address: xiaoyizou@163.com.
authors.forename: Xiaoyi
authors.initials: X
authors.lastname: Zou
mesh_terms: D006801:Humans; D020190:Myoclonic Epilepsy, Juvenile / Q000000981:diagnostic imaging*; D066244:Proton Magnetic Resonance Spectroscopy / Q000379:methods*