title: Juvenile myoclonic epilepsy may be a disorder of cortex rather than thalamus: An effective connectivity analysis.
abstract: Although juvenile myoclonic epilepsy has been considered as a disorder of thalamo-cortical circuit, it is not determined the causality relationship between thalamus and cortex. The aim of this study was to evaluate whether juvenile myoclonic epilepsy is a disorder of thalamus or cortex. Twenty-nine patients with juvenile myoclonic epilepsy and 20 normal controls were enrolled in this study. In addition, we included 10 patients with childhood absence epilepsy as a disease control group. Using whole-brain T1-weighted MRIs, we analyzed the volumes of the structures, including hippocampus, thalamus, and total cortex, with FreeSurfer 5.1. We also investigated the effective connectivity among these structures using SPSS Amos 21 based on these volumetric measures. The structural volumes in juvenile myoclonic epilepsy were not different from those in normal controls. There was a statistically significant effective connectivity from the total cortex to the thalamus in the patients with juvenile myoclonic epilepsy. In addition, a significant effective connectivity from the hippocampus to the ipsilateral thalamus was revealed. Unlike the patients with juvenile myoclonic epilepsy, neither the patients with childhood absence epilepsy nor normal controls had a significant effective connectivity from the total cortex to the thalamus or from the thalamus to the cortex. The connectivity of brain in patients with juvenile myoclonic epilepsy could be different from that in patients with childhood absence epilepsy, and the cortex rather than the thalamus might play a critical role in the pathogenesis of juvenile myoclonic epilepsy.
authors.affiliation: Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, South Korea.
authors.forename: Kang Min
authors.initials: KM
authors.lastname: Park
authors.affiliation: Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, South Korea.
authors.forename: Byung In
authors.initials: BI
authors.lastname: Lee
authors.affiliation: Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, South Korea.
authors.forename: Kyong Jin
authors.initials: KJ
authors.lastname: Shin
authors.affiliation: Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, South Korea.
authors.forename: Sam Yeol
authors.initials: SY
authors.lastname: Ha
authors.affiliation: Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, South Korea.
authors.forename: JinSe
authors.initials: J
authors.lastname: Park
authors.affiliation: Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, South Korea.
authors.forename: Si Eun
authors.initials: SE
authors.lastname: Kim
authors.affiliation: Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, South Korea.
authors.forename: Hyung Chan
authors.initials: HC
authors.lastname: Kim
authors.affiliation: Department of Health Science and Technology, Inje University, Gimhae, South Korea.
authors.forename: Tae Hyung
authors.initials: TH
authors.lastname: Kim
authors.affiliation: Department of Health Science and Technology, Inje University, Gimhae, South Korea; Department of Biomedical Engineering/u-HARC, Inje University, Gimhae, South Korea.
authors.forename: Chi Woong
authors.initials: CW
authors.lastname: Mun
authors.affiliation: Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, South Korea. Electronic address: epidoc@inje.ac.kr.
authors.forename: Sung Eun
authors.initials: SE
authors.lastname: Kim
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000368:Aged; D002540:Cerebral Cortex / Q000000981:diagnostic imaging / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D066128:Gray Matter / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D008959:Models, Neurological; D020190:Myoclonic Epilepsy, Juvenile / Q000000981:diagnostic imaging / Q000473:pathology*; D009434:Neural Pathways / Q000000981:diagnostic imaging / Q000473:pathology; D013788:Thalamus / Q000000981:diagnostic imaging / Q000473:pathology*; D055815:Young Adult
keywords: Epilepsy; Gray matter; Thalamus