Nerve fiber impairment of anterior thalamocortical circuitry in juvenile myoclonic epilepsy

Neurology. 2008 Dec 9;71(24):1981-5. doi: 10.1212/01.wnl.0000336969.98241.17.


Background: Juvenile myoclonic epilepsy (JME) is a syndrome of idiopathic generalized epilepsy (IGE) without structural brain abnormalities detectable by MRI or CT.

Objective: In the present study, we addressed the question of whether diffusion tensor MRI (DTI) can detect disease-specific white matter (WM) abnormalities in patients with JME.

Methods: We performed whole head DTI at 3 T in 10 patients with JME, 8 age-matched patients with cryptogenic partial epilepsy (CPE), and 67 age-matched healthy volunteers. Nerve fiber integrity was compared between the groups on the basis of optimized voxel-by-voxel statistics of fractional anisotropy (FA) maps obtained by DTI (analysis of covariance, categorical factor "group," covariate "age").

Results: FA was reduced in a WM region associated with the anterior thalamus and prefrontal cortex in patients with JME compared to both control subjects and patients with CPE (p < 0.001). The patients with CPE showed normal values in this particular WM region. The FA reductions in the patients with JME correlated with the frequency of generalized tonic-clonic seizures (Spearman R = 0.54, p = 0.05). No significant correlations were found in the JME sample between FA reduction and the duration of antiepileptic medication.

Conclusions: The results support the hypothesis that juvenile myoclonic epilepsy is associated with abnormalities of the thalamocortical network that can be detected by diffusion tensor MRI.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anisotropy
  • Brain Mapping
  • Cerebral Cortex / pathology*
  • Cerebral Cortex / physiopathology
  • Cognition Disorders / etiology
  • Cognition Disorders / pathology
  • Cognition Disorders / physiopathology
  • Diffusion Magnetic Resonance Imaging
  • Disease Progression
  • Female
  • Humans
  • Male
  • Myoclonic Epilepsy, Juvenile / pathology*
  • Myoclonic Epilepsy, Juvenile / physiopathology
  • Nerve Fibers, Myelinated / metabolism
  • Nerve Fibers, Myelinated / pathology*
  • Nerve Net / pathology
  • Nerve Net / physiopathology
  • Neural Pathways / pathology
  • Neural Pathways / physiopathology
  • Predictive Value of Tests
  • Prefrontal Cortex / pathology
  • Prefrontal Cortex / physiopathology
  • Seizures / pathology
  • Seizures / physiopathology
  • Thalamus / pathology*
  • Thalamus / physiopathology
  • Wallerian Degeneration / etiology
  • Wallerian Degeneration / pathology
  • Wallerian Degeneration / physiopathology
  • Young Adult