Table_4_Correlations Between Structural Brain Abnormalities, Cognition and Electroclinical Characteristics in Patients With Juvenile Myoclonic Epilepsy.docx

ObjectiveTo explore the structural brain abnormality and its relationship with neuropsychological disorders and electroclinical characteristics in juvenile myoclonic epilepsy (JME) patients.MethodsSixty-seven patients diagnosed with JME and 56 healthy controls were enrolled. All subjects underwent MRI using T1-weighted 3D brain structural images with 1 mm thickness. Voxel-based morphometry (VBM) and surface-based morphometry (SBM) analyses were performed. They also underwent a series of neuropsychological tests to assess cognitive function. The correlation analyses were conducted between structural changes, neuropsychological outcomes, and electroclinical features.ResultsThe gray matter concentration (GMC) was decreased in the bilateral pre-central and post-central gyrus, right anterior cingulate gyrus, left posterior orbital region, bilateral occipital regions, bilateral hippocampus and bilateral caudate nucleus in the JME groups (corrected P < 0.05). The evaluation of gray matter volume (GMV) showed significant decrease respectively in bilateral pre-central and post-central gyrus, left paracentral lobule, left orbital gyrus, left amygdala, left basal ganglia and left thalamus of JME patients (P < 0.05). The cortex thicknesses of the right inferior temporal gyrus, right insular gyrus, and right cingulate gyrus had negative correlations with the disease duration significantly. At the same time, the whole-brain white matter volume was positively associated with the course of the disease (P < 0.05). Patients with persistent abnormal EEG discharges had significantly less whole-brain gray matter volume than JME patients with normal EEG (P = 0.03). Correlation analyses and linear regression analyses showed that, in addition to the gray matter volumes of frontal and parietal lobe, the temporal lobe, as well as the basal ganglia and thalamus, were also significantly correlated with neuropsychological tests' results (P < 0.05).ConclusionThe JME patients showed subtle structural abnormalities in multiple brain regions that were not only limited to the frontal lobe but also included the thalamus, basal ganglia, parietal lobe, temporal lobe and some occipital cortex, with significant involvement of the primary somatosensory cortex and primary motor cortex. And we significantly demonstrated a correlation between structural abnormalities and cognitive impairment. In addition, the course of disease and abnormal discharges had a specific negative correlation with the structural changes.

本研究旨在探讨青少年肌阵挛性癫痫（JME）患者脑结构异常及其与神经心理学障碍及电生理特征之间的关系。研究方法中，纳入了67名JME患者和56名健康对照者。所有受试者均接受了T1加权3D脑结构成像的MRI扫描，层厚为1毫米。对受试者进行了基于体素形态计量学（VBM）和基于表面形态计量学（SBM）的分析。此外，受试者还进行了系列神经心理学测试以评估认知功能。通过相关性分析，探讨了结构变化、神经心理学结果和电生理特征之间的关系。结果显示，JME患者组在双侧中央前回、中央后回、右侧前扣带回、左侧后眶区、双侧枕叶、双侧海马体和双侧尾状核的灰质浓度（GMC）降低（校正P < 0.05）。灰质体积（GMV）评估显示，JME患者的双侧中央前回、左侧旁中央叶、左侧眶回、左侧杏仁核、左侧基底神经节和左侧丘脑体积显著减小（P < 0.05）。右侧颞下回、右侧岛叶和右侧扣带回的皮质厚度与疾病持续时间存在显著负相关。同时，全脑白质体积与疾病进程呈正相关（P < 0.05）。持续异常脑电图放电的患者与正常脑电图放电的JME患者相比，全脑灰质体积显著减小（P = 0.03）。相关性分析和线性回归分析显示，除了额叶和顶叶的灰质体积外，颞叶以及基底神经节和丘脑也与神经心理学测试结果显著相关（P < 0.05）。结论：JME患者在多个脑区存在微妙的结构性异常，不仅限于额叶，还包括丘脑、基底神经节、顶叶、颞叶以及部分枕叶皮质，其中初级躯体感觉皮层和初级运动皮层受到显著影响。此外，我们还显著证明了结构异常与认知障碍之间的相关性。此外，疾病进程和异常放电与结构变化存在特定的负相关性。