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Sim Y, Lee SK, Chu MK, Kim WJ, Heo K, Kim KM, Sohn B. MRI-Based Radiomics Approach for Differentiating Juvenile Myoclonic Epilepsy from Epilepsy with Generalized Tonic-Clonic Seizures Alone. J Magn Reson Imaging 2024; 60:281-288. [PMID: 37814782 DOI: 10.1002/jmri.29024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Revised: 09/07/2023] [Accepted: 09/08/2023] [Indexed: 10/11/2023] Open
Abstract
BACKGROUND The clinical presentation of juvenile myoclonic epilepsy (JME) and epilepsy with generalized tonic-clonic seizures alone (GTCA) is similar, and MRI scans are often perceptually normal in both conditions making them challenging to differentiate. PURPOSE To develop and validate an MRI-based radiomics model to accurately diagnose JME and GTCA, as well as to classify prognostic groups. STUDY TYPE Retrospective. POPULATION 164 patients (127 with JME and 37 with GTCA) patients (age 24.0 ± 9.6; 50% male), divided into training (n = 114) and test (n = 50) sets in a 7:3 ratio with the same proportion of JME and GTCA patients kept in both sets. FIELD STRENGTH/SEQUENCE 3T; 3D T1-weighted spoiled gradient-echo. ASSESSMENT A total of 17 region-of-interest in the brain were identified as having clinical evidence of association with JME and GTCA, from where 1581 radiomics features were extracted for each subject. Forty-eight machine-learning combinations of oversampling, feature selection, and classification algorithms were explored to develop an optimal radiomics model. The performance of the best radiomics models for diagnosis and for classification of the favorable outcome group were evaluated in the test set. STATISTICAL TESTS Model performance measured using area under the curve (AUC) of receiver operating characteristic (ROC) curve. Shapley additive explanations (SHAP) analysis to estimate the contribution of each radiomics feature. RESULTS The AUC (95% confidence interval) of the best radiomics models for diagnosis and for classification of favorable outcome group were 0.767 (0.591-0.943) and 0.717 (0.563-0.871), respectively. SHAP analysis revealed that the first-order and textural features of the caudate, cerebral white matter, thalamus proper, and putamen had the highest importance in the best radiomics model. CONCLUSION The proposed MRI-based radiomics model demonstrated the potential to diagnose JME and GTCA, as well as to classify prognostic groups. MRI regions associated with JME, such as the basal ganglia, thalamus, and cerebral white matter, appeared to be important for constructing radiomics models. LEVEL OF EVIDENCE 3 TECHNICAL EFFICACY: Stage 3.
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Affiliation(s)
- Yongsik Sim
- Department of Radiology and Research, Institute of Radiological Science and Center for Clinical Imaging Data Science, Yonsei University College of Medicine, Seoul, Korea
| | - Seung-Koo Lee
- Department of Radiology and Research, Institute of Radiological Science and Center for Clinical Imaging Data Science, Yonsei University College of Medicine, Seoul, Korea
| | - Min Kyung Chu
- Department of Neurology, Epilepsy Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Won-Joo Kim
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Kyoung Heo
- Department of Neurology, Epilepsy Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Kyung Min Kim
- Department of Neurology, Epilepsy Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Beomseok Sohn
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Acar D, Ozcelik EU, Baykan B, Bebek N, Demiralp T, Bayram A. Diffusion tensor imaging in photosensitive and nonphotosensitive juvenile myoclonic epilepsy. Seizure 2024; 115:36-43. [PMID: 38183826 DOI: 10.1016/j.seizure.2023.12.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 11/27/2023] [Accepted: 12/22/2023] [Indexed: 01/08/2024] Open
Abstract
INTRODUCTION/BACKGROUND Juvenile myoclonic epilepsy (JME) syndrome is known to cause alterations in brain structure and white matter integrity. The study aimed to determine structural white matter changes in patients with JME and to reveal the differences between the photosensitive (PS) and nonphotosensitive (NPS) subgroups by diffusion tensor imaging (DTI) using the tract-based spatial statistics (TBSS) method. METHODS This study included data from 16 PS, 15 NPS patients with JME, and 41 healthy participants. The mean fractional anisotropy (FA) values of these groups were calculated, and comparisons were made via the TBSS method over FA values in the whole-brain and 81 regions of interest (ROI) obtained from the John Hopkins University White Matter Atlas. RESULTS In the whole-brain TBSS analysis, no significant differences in FA values were observed in pairwise comparisons of JME patient group and subgroups with healthy controls (HCs) and in comparison between JME subgroups. In ROI-based TBSS analysis, an increase in FA values of right anterior corona radiata and left corticospinal pathways was found in JME patient group compared with HC group. When comparing JME-PS patients with HCs, an FA increase was observed in the bilateral anterior corona radiata region, whereas when comparing JME-NPS patients with HCs, an FA increase was observed in bilateral corticospinal pathway. Moreover, in subgroup comparison, an increase in FA values was noted in corpus callosum genu region in JME-PS compared with JME-NPS. CONCLUSIONS Our results support the disruption in thalamofrontal white matter integrity in JME, and subgroups and highlight the importance of using different analysis methods to show the underlying microstructural changes.
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Affiliation(s)
- Dilan Acar
- Department of Neuroscience, Aziz Sancar Institute of Experimental Medicine, Istanbul University, Istanbul, Türkiye; Hulusi Behçet Life Sciences Research Laboratory, Istanbul University, Istanbul, Türkiye
| | - Emel Ur Ozcelik
- Departments of Neurology and Clinical Neurophysiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Türkiye; Department of Neurology, Istanbul Kanuni Sultan Suleyman Training and Research Hospital, University of Health Sciences, Istanbul, Türkiye.
| | - Betül Baykan
- Departments of Neurology and Clinical Neurophysiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Türkiye; Department of Neurology, Istanbul EMAR Medical Center, Istanbul, Türkiye
| | - Nerses Bebek
- Departments of Neurology and Clinical Neurophysiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Türkiye
| | - Tamer Demiralp
- Department of Physiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Türkiye
| | - Ali Bayram
- Department of Neuroscience, Aziz Sancar Institute of Experimental Medicine, Istanbul University, Istanbul, Türkiye; Hulusi Behçet Life Sciences Research Laboratory, Istanbul University, Istanbul, Türkiye
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Kreilkamp BAK, Stier C, Rauf EH, Martin P, Ethofer S, Lerche H, Kotikalapudi R, Marquetand J, Dechent P, Focke NK. Multi-spectral diffusion MRI mega-analysis in genetic generalized epilepsy: Relation to outcomes. Neuroimage Clin 2023; 39:103474. [PMID: 37441820 PMCID: PMC10509527 DOI: 10.1016/j.nicl.2023.103474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 07/05/2023] [Accepted: 07/07/2023] [Indexed: 07/15/2023]
Abstract
BACKGROUND AND OBJECTIVES Genetic generalized epilepsy (GGE) is the most common form of generalized epilepsy. Although individual patients with GGE typically present without structural alterations, group differences have been demonstrated in GGE and some GGE subtypes like juvenile myoclonic epilepsy (GGE-JME). Previous studies usually involved only small cohorts from single centers and therefore could not assess imaging markers of multiple GGE subtypes. METHODS We performed a diffusion MRI mega-analysis in 192 participants consisting of 126 controls and 66 patients with GGE from four different cohorts and two different epilepsy centers. We applied whole-brain multi-site harmonization and analyzed fractional anisotropy (FA), as well as mean, radial and axial diffusivity (MD/RD/AD) to assess differences between controls, patients with GGE and the common GGE subtypes, i.e. GGE with generalized tonic-clonic seizures only (GGE-GTCS), GGE-JME and absence epilepsy (GGE-AE). We also analyzed relationships with patients' response to anti-seizure-medication (ASM). RESULTS Relative to controls, we identified decreased anisotropy and increased RD in patients with GGE. We found no significant effects of disease duration, age of onset or seizure frequency on diffusion metrics. Patients with JME had increased MD and RD when compared to controls, while patients with GGE-GTCS showed decreased MD/AD when compared to controls. Compared to patients with GGE-AE, patients with GGE-GTCS had lower AD/MD. Compared to patients with GGE-GTCS, patients with GGE-JME had higher MD/RD and AD. Moreover, we found lower FA in patients with refractory when compared to patients with non-refractory GGE in the right cortico-spinal tract, but no significant differences in patients with active versus controlled epilepsy. DISCUSSION We provide evidence that clinically defined GGE as a whole and GGE-subtypes harbor marked microstructural differences detectable with diffusion MRI. Moreover, we found an association between microstructural changes and treatment resistance. Our findings have important implications for future full-resolution multi-site studies when assessing GGE, its subtypes and ASM refractoriness.
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Affiliation(s)
| | - Christina Stier
- Clinic for Neurology, University Medical Center Göttingen, Göttingen, Germany; Department of Neurology and Epileptology, Hertie Institute of Clinical Brain Research, University of Tübingen, Tübingen, Germany.
| | - Erik H Rauf
- Clinic for Neurology, University Medical Center Göttingen, Göttingen, Germany.
| | - Pascal Martin
- Department of Neurology and Epileptology, Hertie Institute of Clinical Brain Research, University of Tübingen, Tübingen, Germany.
| | - Silke Ethofer
- Department of Neurosurgery, University of Tübingen, Tübingen, Germany.
| | - Holger Lerche
- Department of Neurology and Epileptology, Hertie Institute of Clinical Brain Research, University of Tübingen, Tübingen, Germany.
| | - Raviteja Kotikalapudi
- Laboratory for Predictive Neuroimaging, University of Duisburg-Essen, Essen, Germany
| | - Justus Marquetand
- Department of Neurology and Epileptology, Hertie Institute of Clinical Brain Research, University of Tübingen, Tübingen, Germany; Department of Neural Dynamics and Magnetoencephalography, Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany; MEG-Center, University of Tübingen, Tübingen, Germany.
| | - Peter Dechent
- Department of Cognitive Neurology, University Medical Center Göttingen, Göttingen, Germany.
| | - Niels K Focke
- Clinic for Neurology, University Medical Center Göttingen, Göttingen, Germany.
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Lee HJ, Lee DA, Park KM. Altered Cerebellar Volumes and Intrinsic Cerebellar Network in Juvenile Myoclonic Epilepsy. Acta Neurol Scand 2023. [DOI: 10.1155/2023/7907887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
Abstract
Objectives. This study is aimed at investigating the alterations in cerebellar volumes and intrinsic cerebellar network in patients with juvenile myoclonic epilepsy (JME) in comparison with healthy controls. Methods. Patients newly diagnosed with JME and healthy controls were enrolled. Three-dimensional T1-weighted imaging was conducted, and no structural lesions were found on brain magnetic resonance imaging. Cerebellar volumes were obtained using the ACAPULCO program, while the intrinsic cerebellar network was evaluated by applying graph theory using the BRAPH program. The nodes were defined as individual cerebellar volumes and edges as partial correlations, controlling for the effects of age and sex. Cerebellar volumes and intrinsic cerebellar networks were compared between the two groups. Results. Forty-five patients with JME and 45 healthy controls were enrolled. Compared with the healthy controls, the patients with JME had significantly lower volumes of the right and left cerebellar white matter (3.33 vs. 3.48%,
; 3.35 vs. 3.49%,
), corpus medullare (0.99 vs. 1.03%,
), and left lobule V (0.19 vs. 0.22%,
). The intrinsic cerebellar networks also showed significant differences between the two groups. The small-worldness index in the patients with JME was significantly lower than that in the healthy controls (0.771 vs. 0.919,
). Conclusion. The cerebellar volumes and intrinsic cerebellar network demonstrated alterations in the patients with JME when compared with those of the healthy controls. Our study results provide evidence that the cerebellum may play a role in the pathogenesis of JME.
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Çavdar S, Köse B, Altınöz D, Özkan M, Güneş YC, Algın O. The brainstem connections of the supplementary motor area and its relations to the corticospinal tract: Experimental rat and human 3-tesla tractography study. Neurosci Lett 2023; 798:137099. [PMID: 36720343 DOI: 10.1016/j.neulet.2023.137099] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 01/25/2023] [Accepted: 01/25/2023] [Indexed: 01/29/2023]
Abstract
Although the supplementary motor area (SMA) is a large region on the medial surface of the frontal lobe of the brain, little is known about its function. The current study uses 3-tesla high-resolution diffusion tensor tractography (DTI) in healthy individuals and biotinylated dextran amine (BDA) and fluoro-gold (FG) tracer in rats to demonstrate the afferent and efferent connections of the SMA with brainstem structures. It also aims to clarify how SMA fibers relate to the corticospinal tract (CST). The BDA (n = 6) and FG (n = 8) tracers were pressure-injected into the SMA of 14 Wistar albino rats. Light and fluorescence microscopy was used to capture images of the FG and BDA-labeled cells and axons. High-resolution 3-tesla DTI data were acquired from the Human Connectome Project database. Tracts between the SMA and brainstem structures were analyzed using diffusion spectrum imaging (DSI) studio software. The FG injections into the SMA showed afferent projections from mesencephalic (periaqueductal gray matter, substantia nigra pars reticulata, ventral tegmental area, inferior colliculus, mesencephalic reticular, tegmental, and raphe nuclei), pontine (locus coeruleus, pontine reticular and vestibular nuclei), and medullary (area postrema, parabrachial, and medullary reticular nuclei) structures. The anterograde tracer BDA injections into the SMA showed efferent connections with mesencephalic (periaqueductal gray, substantia nigra pars compacta, dorsal raphe, trigeminal motor mesencephalic, and mesencephalic reticular nuclei), pontine (locus coeruleus, nucleus of the lateral lemniscus, vestibular, cochlear, and pontine reticular nuclei), and medullary (area postrema, medullary reticular, olivary, and parabrachial nuclei) structures. The SMA had efferent but no afferent connections with the cerebellar nuclei. The DTI results in healthy human subjects highly corresponded with the experimental results. Further, the DTI results showed a distinct bundle that descended to spinal levels closely related to the CST. Understanding SMA's afferent and efferent connections will enrich our knowledge of its contribution to various brainstem networks and may provide new perspectives for understanding its motor and non-motor functions.
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Affiliation(s)
- Safiye Çavdar
- Department of Anatomy, Koç University, School of Medicine, Istanbul, Turkey.
| | - Büşra Köse
- Department of Anatomy, Koç University, School of Medicine, Istanbul, Turkey
| | - Damlasu Altınöz
- Department of Anatomy, Koç University, School of Medicine, Istanbul, Turkey
| | - Mazhar Özkan
- Department of Anatomy, Tekirdağ Namık Kemal University, School of Medicine, Istanbul, Turkey
| | - Yasin Celal Güneş
- Department of Radiology, Ankara Bilkent City Hospital, Ankara, Turkey; Department of Radiology, Ankara Atatürk Sanatorium Training and Research Hospital, Ankara, Turkey
| | - Oktay Algın
- Department of Radiology, Ankara Atatürk Sanatorium Training and Research Hospital, Ankara, Turkey; Yıldırım Beyazıt University, Medical Faculty, Ankara, Turkey; National MR Research Center (UMRAM), Bilkent University, Ankara, Turkey
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Wang M, Cheng X, Shi Q, Xu B, Hou X, Zhao H, Gui Q, Wu G, Dong X, Xu Q, Shen M, Cheng Q, Xue S, Feng H, Ding Z. Brain diffusion tensor imaging reveals altered connections and networks in epilepsy patients. Front Hum Neurosci 2023; 17:1142408. [PMID: 37033907 PMCID: PMC10073437 DOI: 10.3389/fnhum.2023.1142408] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 02/28/2023] [Indexed: 04/11/2023] Open
Abstract
Introduction Accumulating evidence shows that epilepsy is a disease caused by brain network dysfunction. This study explored changes in brain network structure in epilepsy patients based on graph analysis of diffusion tensor imaging data. Methods The brain structure networks of 42 healthy control individuals and 26 epilepsy patients were constructed. Using graph theory analysis, global and local network topology parameters of the brain structure network were calculated, and changes in global and local characteristics of the brain network in epilepsy patients were quantitatively analyzed. Results Compared with the healthy control group, the epilepsy patient group showed lower global efficiency, local efficiency, clustering coefficient, and a longer shortest path length. Both healthy control individuals and epilepsy patients showed small-world attributes, with no significant difference between groups. The epilepsy patient group showed lower nodal local efficiency and nodal clustering coefficient in the right olfactory cortex and right rectus and lower nodal degree centrality in the right olfactory cortex and the left paracentral lobular compared with the healthy control group. In addition, the epilepsy patient group showed a smaller fiber number of edges in specific regions of the frontal lobe, temporal lobe, and default mode network, indicating reduced connection strength. Discussion Epilepsy patients exhibited lower global and local brain network properties as well as reduced white matter fiber connectivity in key brain regions. These findings further support the idea that epilepsy is a brain network disorder.
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Affiliation(s)
- Meixia Wang
- Department of Neurology, Suzhou Hospital Affiliated to Nanjing Medical University, Suzhou Municipal Hospital, Suzhou, China
| | - Xiaoyu Cheng
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Qianru Shi
- Department of Neurology, Suzhou Hospital Affiliated to Nanjing Medical University, Suzhou Municipal Hospital, Suzhou, China
| | - Bo Xu
- Department of Neurology, Suzhou Hospital Affiliated to Nanjing Medical University, Suzhou Municipal Hospital, Suzhou, China
| | - Xiaoxia Hou
- Department of Neurology, Suzhou Hospital Affiliated to Nanjing Medical University, Suzhou Municipal Hospital, Suzhou, China
| | - Huimin Zhao
- Department of Neurology, Suzhou Hospital Affiliated to Nanjing Medical University, Suzhou Municipal Hospital, Suzhou, China
| | - Qian Gui
- Department of Neurology, Suzhou Hospital Affiliated to Nanjing Medical University, Suzhou Municipal Hospital, Suzhou, China
| | - Guanhui Wu
- Department of Neurology, Suzhou Hospital Affiliated to Nanjing Medical University, Suzhou Municipal Hospital, Suzhou, China
| | - Xiaofeng Dong
- Department of Neurology, Suzhou Hospital Affiliated to Nanjing Medical University, Suzhou Municipal Hospital, Suzhou, China
| | - Qinrong Xu
- Department of Neurology, Suzhou Hospital Affiliated to Nanjing Medical University, Suzhou Municipal Hospital, Suzhou, China
| | - Mingqiang Shen
- Department of Neurology, Suzhou Hospital Affiliated to Nanjing Medical University, Suzhou Municipal Hospital, Suzhou, China
| | - Qingzhang Cheng
- Department of Neurology, Suzhou Hospital Affiliated to Nanjing Medical University, Suzhou Municipal Hospital, Suzhou, China
| | - Shouru Xue
- Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Hongxuan Feng
- Department of Neurology, Suzhou Hospital Affiliated to Nanjing Medical University, Suzhou Municipal Hospital, Suzhou, China
- *Correspondence: Hongxuan Feng,
| | - Zhiliang Ding
- Department of Neurology, Suzhou Hospital Affiliated to Nanjing Medical University, Suzhou Municipal Hospital, Suzhou, China
- Zhiliang Ding,
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Hu J, Ran H, Chen G, He Y, Li Q, Liu J, Li F, Liu H, Zhang T. Altered neurovascular coupling in children with idiopathic generalized epilepsy. CNS Neurosci Ther 2022; 29:609-618. [PMID: 36480481 PMCID: PMC9873522 DOI: 10.1111/cns.14039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 11/09/2022] [Accepted: 11/13/2022] [Indexed: 12/13/2022] Open
Abstract
AIMS Alterations in neuronal activity and cerebral hemodynamics have been reported in idiopathic generalized epilepsy (IGE) patients, possibly resulting in neurovascular decoupling; however, no neuroimaging evidence confirmed this disruption. This study aimed to investigate the possible presence of neurovascular decoupling and its clinical implications in childhood IGE using resting-state fMRI and arterial spin labeling imaging. METHODS IGE patients and healthy participants underwent resting-state fMRI and arterial spin labeling imaging to calculate degree centrality (DC) and cerebral blood flow (CBF), respectively. Across-voxel CBF-DC correlations were analyzed to evaluate the neurovascular coupling within the whole gray matter, and the regional coupling of brain region was assessed with the CBF/DC ratio. RESULTS The study included 26 children with IGE and 35 sex- and age-matched healthy controls (HCs). Compared with the HCs, the IGE group presented lower across-voxel CBF-DC correlations, higher CBF/DC ratio in the right posterior cingulate cortex/precuneus, middle frontal gyrus, and medial frontal gyrus (MFG), and lower ratio in the left inferior frontal gyrus. The increased CBF/DC ratio in the right MFG was correlated with lower performance intelligence quotient scores in the IGE group. CONCLUSION Children with IGE present altered neurovascular coupling, associated with lower performance intelligence quotient scores. The study shed a new insight into the pathophysiology of epilepsy and provided potential imaging biomarkers of cognitive performances in children with IGE.
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Affiliation(s)
- Jie Hu
- Department of RadiologyThe Affiliated Hospital of Zunyi Medical University, Medical Imaging Center of Guizhou ProvinceZunyiChina,Department of Radiology and Nuclear MedicineXuanwu Hospital, Capital Medical UniversityBeijingChina
| | - Haifeng Ran
- Department of RadiologyThe Affiliated Hospital of Zunyi Medical University, Medical Imaging Center of Guizhou ProvinceZunyiChina
| | - Guiqin Chen
- Department of RadiologyThe Affiliated Hospital of Zunyi Medical University, Medical Imaging Center of Guizhou ProvinceZunyiChina
| | - Yulun He
- Department of RadiologyThe Affiliated Hospital of Zunyi Medical University, Medical Imaging Center of Guizhou ProvinceZunyiChina
| | - Qinghui Li
- Department of RadiologyThe Affiliated Hospital of Zunyi Medical University, Medical Imaging Center of Guizhou ProvinceZunyiChina
| | - Junwei Liu
- Department of RadiologyThe Affiliated Hospital of Zunyi Medical University, Medical Imaging Center of Guizhou ProvinceZunyiChina
| | - Fangling Li
- Department of RadiologyThe Affiliated Hospital of Zunyi Medical University, Medical Imaging Center of Guizhou ProvinceZunyiChina
| | - Heng Liu
- Department of RadiologyThe Affiliated Hospital of Zunyi Medical University, Medical Imaging Center of Guizhou ProvinceZunyiChina
| | - Tijiang Zhang
- Department of RadiologyThe Affiliated Hospital of Zunyi Medical University, Medical Imaging Center of Guizhou ProvinceZunyiChina
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Kim KM, Hwang H, Sohn B, Park K, Han K, Ahn SS, Lee W, Chu MK, Heo K, Lee SK. Development and Validation of MRI-Based Radiomics Models for Diagnosing Juvenile Myoclonic Epilepsy. Korean J Radiol 2022; 23:1281-1289. [PMID: 36447416 PMCID: PMC9747272 DOI: 10.3348/kjr.2022.0539] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 09/21/2022] [Accepted: 09/26/2022] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVE Radiomic modeling using multiple regions of interest in MRI of the brain to diagnose juvenile myoclonic epilepsy (JME) has not yet been investigated. This study aimed to develop and validate radiomics prediction models to distinguish patients with JME from healthy controls (HCs), and to evaluate the feasibility of a radiomics approach using MRI for diagnosing JME. MATERIALS AND METHODS A total of 97 JME patients (25.6 ± 8.5 years; female, 45.5%) and 32 HCs (28.9 ± 11.4 years; female, 50.0%) were randomly split (7:3 ratio) into a training (n = 90) and a test set (n = 39) group. Radiomic features were extracted from 22 regions of interest in the brain using the T1-weighted MRI based on clinical evidence. Predictive models were trained using seven modeling methods, including a light gradient boosting machine, support vector classifier, random forest, logistic regression, extreme gradient boosting, gradient boosting machine, and decision tree, with radiomics features in the training set. The performance of the models was validated and compared to the test set. The model with the highest area under the receiver operating curve (AUROC) was chosen, and important features in the model were identified. RESULTS The seven tested radiomics models, including light gradient boosting machine, support vector classifier, random forest, logistic regression, extreme gradient boosting, gradient boosting machine, and decision tree, showed AUROC values of 0.817, 0.807, 0.783, 0.779, 0.767, 0.762, and 0.672, respectively. The light gradient boosting machine with the highest AUROC, albeit without statistically significant differences from the other models in pairwise comparisons, had accuracy, precision, recall, and F1 scores of 0.795, 0.818, 0.931, and 0.871, respectively. Radiomic features, including the putamen and ventral diencephalon, were ranked as the most important for suggesting JME. CONCLUSION Radiomic models using MRI were able to differentiate JME from HCs.
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Affiliation(s)
- Kyung Min Kim
- Department of Neurology, Epilepsy Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Heewon Hwang
- Department of Neurology, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Beomseok Sohn
- Department of Radiology, Severance Hospital, Research Institute of Radiological Science and Centre for Clinical Imaging Data Science, Yonsei University College of Medicine, Seoul, Korea.
| | - Kisung Park
- Department of Radiology, Severance Hospital, Research Institute of Radiological Science and Centre for Clinical Imaging Data Science, Yonsei University College of Medicine, Seoul, Korea.,Department of Mechanical Engineering, Pohang University of Science and Technology, Pohang, Korea
| | - Kyunghwa Han
- Department of Radiology, Severance Hospital, Research Institute of Radiological Science and Centre for Clinical Imaging Data Science, Yonsei University College of Medicine, Seoul, Korea
| | - Sung Soo Ahn
- Department of Radiology, Severance Hospital, Research Institute of Radiological Science and Centre for Clinical Imaging Data Science, Yonsei University College of Medicine, Seoul, Korea
| | - Wonwoo Lee
- Department of Neurology, Yongin Severance Hospital, Yonsei University Health System, Yongin, Korea
| | - Min Kyung Chu
- Department of Neurology, Epilepsy Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Kyoung Heo
- Department of Neurology, Epilepsy Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Seung-Koo Lee
- Department of Radiology, Severance Hospital, Research Institute of Radiological Science and Centre for Clinical Imaging Data Science, Yonsei University College of Medicine, Seoul, Korea
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Uslu FI, Çetintaş E, Yurtseven İ, Alkan A, Kolukisa M. Relationship of white matter hyperintensities with clinical features of seizures in patients with epilepsy. ARQUIVOS DE NEURO-PSIQUIATRIA 2021; 79:1084-1089. [PMID: 34816969 DOI: 10.1590/0004-282x-anp-2021-0003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 04/30/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND Although epilepsy is primarily known as a cortical disorder, there is growing body of research demonstrating white matter alterations in patients with epilepsy. OBJECTIVE To investigate the prevalence of white matter hyperintensities (WMH) and its association with seizure characteristics in patients with epilepsy. METHODS The prevalence of WMH in 94 patients with epilepsy and 41 healthy controls were compared. Within the patient sample, the relationship between the presence of WMH and type of epilepsy, frequency of seizures, duration of disease and the number of antiepileptic medications were investigated. RESULTS The mean age and sex were not different between patients and healthy controls (p>0.2). WMH was present in 27.7% of patients and in 14.6% of healthy controls. Diagnosis of epilepsy was independently associated with the presence of WMH (ß=3.09, 95%CI 1.06-9.0, p=0.039). Patients with focal epilepsy had higher prevalence of WMH (35.5%) than patients with generalized epilepsy (14.7%). The presence of WMH was associated with older age but not with seizure characteristics. CONCLUSIONS WMH is more common in patients with focal epilepsy than healthy controls. The presence of WMH is associated with older age, but not with seizure characteristics.
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Affiliation(s)
- Ferda Ilgen Uslu
- Bezmialem Vakıf University, Medical Faculty, Department of Neurology, Fatih, İstanbul, Turkey
| | - Elif Çetintaş
- Bezmialem Vakıf University, Medical Faculty, Fatih, İstanbul, Turkey
| | - İsmail Yurtseven
- Bezmialem Vakıf University, Medical Faculty, Department of Radiology, Fatih, İstanbul, Turkey
| | - Alpay Alkan
- Bezmialem Vakıf University, Medical Faculty, Department of Radiology, Fatih, İstanbul, Turkey
| | - Mehmet Kolukisa
- Bezmialem Vakıf University, Medical Faculty, Department of Neurology, Fatih, İstanbul, Turkey
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10
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Cerebello-cerebral connectivity in idiopathic generalized epilepsy. Eur Radiol 2020; 30:3924-3933. [DOI: 10.1007/s00330-020-06674-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2019] [Revised: 12/17/2019] [Accepted: 01/24/2020] [Indexed: 12/24/2022]
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11
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Gilsoul M, Grisar T, Delgado-Escueta AV, de Nijs L, Lakaye B. Subtle Brain Developmental Abnormalities in the Pathogenesis of Juvenile Myoclonic Epilepsy. Front Cell Neurosci 2019; 13:433. [PMID: 31611775 PMCID: PMC6776584 DOI: 10.3389/fncel.2019.00433] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 09/09/2019] [Indexed: 12/17/2022] Open
Abstract
Juvenile myoclonic epilepsy (JME), a lifelong disorder that starts during adolescence, is the most common of genetic generalized epilepsy syndromes. JME is characterized by awakening myoclonic jerks and myoclonic-tonic-clonic (m-t-c) grand mal convulsions. Unfortunately, one third of JME patients have drug refractory m-t-c convulsions and these recur in 70-80% who attempt to stop antiepileptic drugs (AEDs). Behavioral studies documented impulsivity, but also impairment of executive functions relying on organization and feedback, which points to prefrontal lobe dysfunction. Quantitative voxel-based morphometry (VBM) revealed abnormalities of gray matter (GM) volumes in cortical (frontal and parietal) and subcortical structures (thalamus, putamen, and hippocampus). Proton magnetic resonance spectroscopy (MRS) found evidence of dysfunction of thalamic neurons. White matter (WM) integrity was disrupted in corpus callosum and frontal WM tracts. Magnetic resonance imaging (MRI) further unveiled anomalies in both GM and WM structures that were already present at the time of seizure onset. Aberrant growth trajectories of brain development occurred during the first 2 years of JME diagnosis. Because of genetic origin, disease causing variants were sought, first by positional cloning, and most recently, by next generation sequencing. To date, only six genes harboring pathogenic variants (GABRA1, GABRD, EFHC1, BRD2, CASR, and ICK) with Mendelian and complex inheritance and covering a limited proportion of the world population, are considered as major susceptibility alleles for JME. Evidence on the cellular role, developmental and cell-type expression profiles of these six diverse JME genes, point to their pathogenic variants driving the first steps of brain development when cell division, expansion, axial, and tangential migration of progenitor cells (including interneuron cortical progenitors) sculpture subtle alterations in brain networks and microcircuits during development. These alterations may explain "microdysgenesis" neuropathology, impulsivity, executive dysfunctions, EEG polyspike waves, and awakening m-t-c convulsions observed in JME patients.
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Affiliation(s)
- Maxime Gilsoul
- GIGA-Stem Cells, University of Liège, Liège, Belgium
- GIGA-Neurosciences, University of Liège, Liège, Belgium
- GENESS International Consortium, Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - Thierry Grisar
- GENESS International Consortium, Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - Antonio V. Delgado-Escueta
- GENESS International Consortium, Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
- Epilepsy Genetics/Genomics Lab, Neurology and Research Services, VA Greater Los Angeles Healthcare System, Los Angeles, CA, United States
| | - Laurence de Nijs
- GENESS International Consortium, Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
- School for Mental Health and Neuroscience, Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, Netherlands
| | - Bernard Lakaye
- GIGA-Stem Cells, University of Liège, Liège, Belgium
- GIGA-Neurosciences, University of Liège, Liège, Belgium
- GENESS International Consortium, Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
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12
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Lee H, Park KM. Structural and functional connectivity in newly diagnosed juvenile myoclonic epilepsy. Acta Neurol Scand 2019; 139:469-475. [PMID: 30758836 DOI: 10.1111/ane.13079] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Accepted: 02/10/2019] [Indexed: 01/02/2023]
Abstract
OBJECTIVES We aimed to evaluate structural and functional connectivity of patients with newly diagnosed juvenile myoclonic epilepsy (JME) compared to healthy subjects. METHODS We enrolled 36 patients with a diagnosis of JME, who were newly diagnosed and drug-naïve. They underwent T1-weighted imaging, and structural volumes were calculated using FreeSurfer software. In addition, EEG data were obtained from all of them. Structural and functional connectivity matrices were estimated by calculating the structural volumes and EEG amplitude correlation, respectively. Then, the connectivity measures were calculated using the BRAPH program. We also enrolled healthy subjects to compare its structural and functional connectivity with the patients with JME. RESULTS We observed that patients with JME exhibited significantly different functional and structural connectivity compared to healthy control subjects. In the global structural connectivity, global efficiency, and local efficiency, and small-worldness index were decreased, whereas characteristic path length was increased in patients with JME. Betweenness centrality of cingulate, precentral, superior parietal, and superior frontal cortex was increased in patients with JME whereas that of hippocampus was decreased. In the functional connectivity, the betweenness centrality of the fronto-central electrodes was significantly increased. CONCLUSIONS This study reports that the structural connectivity and functional connectivity in patients with JME are significantly different from those in healthy control subjects, even those with newly diagnosed drug-naive state. The patients with JME exhibited disrupted topological disorganization of the global brain network and hub reorganization in structural and functional connectivity. These alterations are implicated in the pathogenesis of JME and suggestive of network disease.
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Affiliation(s)
- Ho‐Joon Lee
- Department of Radiology Haeundae Paik Hospital Busan Korea
| | - Kang Min Park
- Department of Neurology Haeundae Paik Hospital Busan Korea
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13
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Sinha N, Wang Y, Dauwels J, Kaiser M, Thesen T, Forsyth R, Taylor PN. Computer modelling of connectivity change suggests epileptogenesis mechanisms in idiopathic generalised epilepsy. NEUROIMAGE-CLINICAL 2019; 21:101655. [PMID: 30685702 PMCID: PMC6356007 DOI: 10.1016/j.nicl.2019.101655] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Revised: 12/21/2018] [Accepted: 01/03/2019] [Indexed: 12/14/2022]
Abstract
Patients with idiopathic generalised epilepsy (IGE) typically have normal conventional magnetic resonance imaging (MRI), hence diagnosis based on MRI is challenging. Anatomical abnormalities underlying brain dysfunctions in IGE are unclear and their relation to the pathomechanisms of epileptogenesis is poorly understood. In this study, we applied connectometry, an advanced quantitative neuroimaging technique for investigating localised changes in white-matter tissues in vivo. Analysing white matter structures of 32 subjects we incorporated our in vivo findings in a computational model of seizure dynamics to suggest a plausible mechanism of epileptogenesis. Patients with IGE have significant bilateral alterations in major white-matter fascicles. In the cingulum, fornix, and superior longitudinal fasciculus, tract integrity is compromised, whereas in specific parts of tracts between thalamus and the precentral gyrus, tract integrity is enhanced in patients. Combining these alterations in a logistic regression model, we computed the decision boundary that discriminated patients and controls. The computational model, informed with the findings on the tract abnormalities, specifically highlighted the importance of enhanced cortico-reticular connections along with impaired cortico-cortical connections in inducing pathological seizure-like dynamics. We emphasise taking directionality of brain connectivity into consideration towards understanding the pathological mechanisms; this is possible by combining neuroimaging and computational modelling. Our imaging evidence of structural alterations suggest the loss of cortico-cortical and enhancement of cortico-thalamic fibre integrity in IGE. We further suggest that impaired connectivity from cortical regions to the thalamic reticular nucleus offers a therapeutic target for selectively modifying the brain circuit for reversing the mechanisms leading to epileptogenesis. Significant focal alterations along major white-matter fascicles in IGE patients are characterised. Increased white matter integrity found in thalamo-cortical connections. Decreased white matter integrity found in cortico-cortical connections. Disease mechanism is investigated by combining the neuroimaging findings with a dynamical model of seizure activity. Model implicates cortical projections to the thalamic reticular nucleus in IGE.
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Affiliation(s)
- Nishant Sinha
- Institute of Neuroscience, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK; Interdisciplinary Computing and Complex BioSystems Group, School of Computing, Newcastle University, Newcastle upon Tyne, UK.
| | - Yujiang Wang
- Institute of Neuroscience, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK; Interdisciplinary Computing and Complex BioSystems Group, School of Computing, Newcastle University, Newcastle upon Tyne, UK; Institute of Neurology, University College London, UK
| | - Justin Dauwels
- School of Electrical and Electronic Engineering, Nanyang Technological University, Singapore
| | - Marcus Kaiser
- Institute of Neuroscience, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK; Interdisciplinary Computing and Complex BioSystems Group, School of Computing, Newcastle University, Newcastle upon Tyne, UK
| | - Thomas Thesen
- Department of Neurology, School of Medicine, New York University, NY, USA; Department of Physiology and Neuroscience, St. Georges University, Grenada, West Indies
| | - Rob Forsyth
- Institute of Neuroscience, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Peter Neal Taylor
- Institute of Neuroscience, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK; Interdisciplinary Computing and Complex BioSystems Group, School of Computing, Newcastle University, Newcastle upon Tyne, UK; Institute of Neurology, University College London, UK.
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14
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Jia X, Ma S, Jiang S, Sun H, Dong D, Chang X, Zhu Q, Yao D, Yu L, Luo C. Disrupted Coupling Between the Spontaneous Fluctuation and Functional Connectivity in Idiopathic Generalized Epilepsy. Front Neurol 2018; 9:838. [PMID: 30344508 PMCID: PMC6182059 DOI: 10.3389/fneur.2018.00838] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2018] [Accepted: 09/18/2018] [Indexed: 12/11/2022] Open
Abstract
Purpose: The purpose of this study was to comprehensively evaluate alterations of resting-state spontaneous brain activity in patients with idiopathic generalized epilepsy (IGE) and its subgroups [juvenile myoclonic epilepsy (JME) and generalized tonic-clonic seizures (GTCS)]. Methods: Resting state functional magnetic resonance imaging (fMRI) data were acquired from 60 patients with IGE and 60 healthy controls (HCs). Amplitude of low frequency fluctuation (ALFF), global functional connectivity density (gFCD), local FCD (lFCD), and long range FCD (lrFCD) were used to evaluate spontaneous brain activity in the whole brain. Moreover, the coupling between ALFF and FCDs (gFCD, lFCD, and lrFCD) was analyzed on both voxel-wise and subject-wise levels. Two-sample t-tests were used to analyze the difference in ALFF, FCDs and coupling on a subject-wise level between the two groups. Nonparametric permutation tests were used to evaluate differences in coupling on a voxel-wise level. Key findings: Patients with IGE and its subgroups showed reduced ALFF, gFCD and lrFCD in posterior regions of the default mode network (DMN). In addition, decreased ALFF and increased coupling with FCD were found in the cerebellum, while decreased coupling was observed in the bilateral pre- and postcentral gyrus in IGE compared with the coupling in HCs. Similar findings were found in the analysis between each of the two subgroups of IGE (JME and GTCS) and HCs, and JME patients had increased coupling in the cerebellum and bilateral middle occipital gyrus compared with coupling in the GTCS patients. Significance: This study demonstrated a multifactor abnormality of the DMN in IGE and emphasized that the abnormality in the cerebellum was associated with dysfunctional motor symptoms during seizures and might participate in the regulation of GSWDs in IGE.
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Affiliation(s)
- Xiaoyan Jia
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, Center for Information in Medicine, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Shuai Ma
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, Center for Information in Medicine, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
- Neurology Department, Sichuan Provincial People's Hospital, The Affiliated Hospital of University of Electronic Science and Technology of China, Chengdu, China
| | - Sisi Jiang
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, Center for Information in Medicine, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Honbin Sun
- Neurology Department, Sichuan Provincial People's Hospital, The Affiliated Hospital of University of Electronic Science and Technology of China, Chengdu, China
| | - Debo Dong
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, Center for Information in Medicine, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Xuebin Chang
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, Center for Information in Medicine, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Qiong Zhu
- Neurology Department, Sichuan Provincial People's Hospital, The Affiliated Hospital of University of Electronic Science and Technology of China, Chengdu, China
| | - Dezhong Yao
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, Center for Information in Medicine, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Liang Yu
- Neurology Department, Sichuan Provincial People's Hospital, The Affiliated Hospital of University of Electronic Science and Technology of China, Chengdu, China
| | - Cheng Luo
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, Center for Information in Medicine, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
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15
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Domin M, Bartels S, Geithner J, Wang ZI, Runge U, Grothe M, Langner S, von Podewils F. Juvenile Myoclonic Epilepsy Shows Potential Structural White Matter Abnormalities: A TBSS Study. Front Neurol 2018; 9:509. [PMID: 30008695 PMCID: PMC6033991 DOI: 10.3389/fneur.2018.00509] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Accepted: 06/11/2018] [Indexed: 01/16/2023] Open
Abstract
Background: Several studies on patients with juvenile myoclonic epilepsy (JME) showed widespread white matter (WM) abnormalities in the brain. The aim of this study was to investigate potential structural abnormalities in JME patients (1) compared to healthy controls, (2) among JME subgroups with or without photoparoxysmal responses (PPR), and (3) in correlation with clinical variables. Methods: A selection of 31 patients with JME (12 PPR positive) and 27 age and gender matched healthy controls (HC) were studied at a tertiary epilepsy center. Fractional anisotropy (FA) was calculated and intergroup differences analyzed using Tract Based Spatial Statistics (TBSS). Results: Compared to HC the JME group showed reduced FA widespread and bilateral in the longitudinal fasciculus, inferior fronto-occipital fasciculus, corticospinal tract, anterior and posterior thalamic radiation, corona radiata, corpus callosum, cingulate gyrus and external capsule (p < 0.01). Subgroup analysis revealed no significant differences of WM alterations between PPR positive and negative patients and with clinical and epilepsy-related factors. Conclusions: Widespread microstructural abnormalities among patients with JME have been identified.Prior findings of frontal and thalamofrontal microstructural abnormalities have been confirmed. Additionally, microstructural abnormalities were found in widespread extra-frontal regions that may help to validate pathophysiological concepts of JME.
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Affiliation(s)
- Martin Domin
- Functional Imaging Unit, Department of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Greifswald, Germany
| | - Sabine Bartels
- Department of Neurology, Epilepsy Center, University Medicine Greifswald, Greifswald, Germany
| | - Julia Geithner
- Epilepsy Center Berlin-Brandenburg, Ev. Krankenhaus Königin Elisabeth Herzberge, Berlin, Germany
| | - Zhong I Wang
- Epilepsy Center, Neurological Institute, Cleveland Clinic Foundation, Cleveland, OH, United States
| | - Uwe Runge
- Department of Neurology, Epilepsy Center, University Medicine Greifswald, Greifswald, Germany
| | - Matthias Grothe
- Department of Neurology, Epilepsy Center, University Medicine Greifswald, Greifswald, Germany
| | - Soenke Langner
- Diagnostic and Interventional Neuroradiology, University Medicine Rostock, Rostock, Germany
| | - Felix von Podewils
- Department of Neurology, Epilepsy Center, University Medicine Greifswald, Greifswald, Germany
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16
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Jiang S, Luo C, Gong J, Peng R, Ma S, Tan S, Ye G, Dong L, Yao D. Aberrant Thalamocortical Connectivity in Juvenile Myoclonic Epilepsy. Int J Neural Syst 2017; 28:1750034. [PMID: 28830309 DOI: 10.1142/s0129065717500344] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The purpose of this study was to investigate the functional connectivity (FC) of thalamic subdivisions in patients with juvenile myoclonic epilepsy (JME). Resting state functional magnetic resonance imaging (fMRI) and diffusion tensor imaging (DTI) data were acquired from 22 JME and 25 healthy controls. We first divided the thalamus into eight subdivisions by performing independent component analysis on tracking fibers and clustering thalamus-related FC maps. We then analyzed abnormal FC in each subdivision in JME compared with healthy controls, and we investigated their associations with clinical features. Eight thalamic sub-regions identified in the current study showed unbalanced thalamic FC in JME: decreased FC with the superior frontal gyrus and enhanced FC with the supplementary motor area in the posterior thalamus increased thalamic FC with the salience network (SN) and reduced FC with the default mode network (DMN). Abnormalities in thalamo-prefrontocortical networks might be related to the propagation of generalized spikes with frontocentral predominance in JME, and the network connectivity differences with the SN and DMN might be implicated in emotional and cognitive defects in JME. JME was also associated with enhanced FC among thalamic sub-regions and with the basal ganglia and cerebellum, suggesting the regulatory role of subcortical nuclei and the cerebellum on the thalamo-cortical circuit. Additionally, increased FC with the pallidum was positive related with the duration of disease. The present study provides emerging evidence of FC to understand that specific thalamic subdivisions contribute to the abnormalities of thalamic-cortical networks in JME. Moreover, the posterior thalamus could play a crucial role in generalized epileptic activity in JME.
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Affiliation(s)
- S. Jiang
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, Center for Information in Medicine, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, P. R. China
| | - C. Luo
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, Center for Information in Medicine, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, P. R. China
| | - J. Gong
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, Center for Information in Medicine, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, P. R. China
| | - R. Peng
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, Center for Information in Medicine, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, P. R. China
| | - S. Ma
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, Center for Information in Medicine, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, P. R. China
- Neurology Department, Sichuan Provincial People’s Hospital, The affiliated Hospital of University of Electronic Science and Technology of China, University of Electronic Science and Technology of China, Chengdu 610054, P. R. China
| | - S. Tan
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, Center for Information in Medicine, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, P. R. China
- Neurology Department, Sichuan Provincial People’s Hospital, The affiliated Hospital of University of Electronic Science and Technology of China, University of Electronic Science and Technology of China, Chengdu 610054, P. R. China
| | - G. Ye
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, Center for Information in Medicine, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, P. R. China
| | - L. Dong
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, Center for Information in Medicine, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, P. R. China
| | - D. Yao
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, Center for Information in Medicine, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, P. R. China
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17
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Ma S, Jiang S, Peng R, Zhu Q, Sun H, Li J, Jia X, Goldberg I, Yu L, Luo C. Altered Local Spatiotemporal Consistency of Resting-State BOLD Signals in Patients with Generalized Tonic-Clonic Seizures. Front Comput Neurosci 2017; 11:90. [PMID: 29033811 PMCID: PMC5627153 DOI: 10.3389/fncom.2017.00090] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2017] [Accepted: 09/20/2017] [Indexed: 01/09/2023] Open
Abstract
The purpose of this study was to evaluate the spatiotemporal Consistency of spontaneous activities in local brain regions in patients with generalized tonic-clonic seizures (GTCS). The resting-state fMRI data were acquired from nineteen patients with GTCS and twenty-two matched healthy subjects. FOur-dimensional (spatiotemporal) Consistency of local neural Activities (FOCA) metric was used to analyze the spontaneous activity in whole brain. The FOCA difference between two groups were detected using a two sample t-test analysis. Correlations between the FOCA values and features of seizures were analyzed. The findings of this study showed that patients had significantly increased FOCA in motor-related cortex regions, including bilateral supplementary motor area, paracentral lobule, precentral gyrus and left basal ganglia, as well as a substantial reduction of FOCA in regions of default mode network (DMN) and parietal lobe. In addition, several brain regions in DMN demonstrated more reduction with longer duration of epilepsy and later onset age, and the motor-related regions showed higher FOCA value in accompany with later onset age. These findings implicated the abnormality of motor-related cortical network in GTCS which were associated with the genesis and propagation of epileptiform activity. And the decreased FOCA in DMN might reflect the intrinsic disturbance of brain activity. Moreover, our study supported that the FOCA might be potential tool to investigate local brain spontaneous activity related with the epileptic activity, and to provide important insights into understanding the underlying pathophysiological mechanisms of GTCS.
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Affiliation(s)
- Shuai Ma
- Neurology Department, Sichuan Provincial People's Hospital, The Affiliated Hospital of University of Electronic Science and Technology of China, Chengdu, China
| | - Sisi Jiang
- Key Laboratory for NeuroInformation of Ministry of Education, Center for Information in Medicine, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Rui Peng
- Key Laboratory for NeuroInformation of Ministry of Education, Center for Information in Medicine, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Qiong Zhu
- Neurology Department, Sichuan Provincial People's Hospital, The Affiliated Hospital of University of Electronic Science and Technology of China, Chengdu, China
| | - Hongbin Sun
- Neurology Department, Sichuan Provincial People's Hospital, The Affiliated Hospital of University of Electronic Science and Technology of China, Chengdu, China
| | - Jianfu Li
- Key Laboratory for NeuroInformation of Ministry of Education, Center for Information in Medicine, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Xiaoyan Jia
- Key Laboratory for NeuroInformation of Ministry of Education, Center for Information in Medicine, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Ilan Goldberg
- Neurology Department, Wolfson Medical Center, Holon, Israel
| | - Liang Yu
- Neurology Department, Sichuan Provincial People's Hospital, The Affiliated Hospital of University of Electronic Science and Technology of China, Chengdu, China
| | - Cheng Luo
- Key Laboratory for NeuroInformation of Ministry of Education, Center for Information in Medicine, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
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