A Study On Brain Structure And Function Connection Of Juvenile Myoclonic Epilepsy Based On MRI

Objective : Juvenile myoclonic epilepsy(JME)is characterized by transitory,bilateral symmetry,synchronization and unrhythmical muscle jerks,generally with no loss of consciousness.The onset age generally at 8 to 22 years old,there was no significant gender differences.Most of the causes of JME are genetic,episodes of EEG performance for a wide range of regular 4 to 6 Hz spikes and wave discharge,interphase EEG is still visible quickly,widely and irregular spine slow wave,sleep deprivation and flash stimulation can cause seizures,and which need long-term medication control,valproate is an effective drug for the control of seizure.In recent years,wide application of high resolution imaging technology and the research method with synchronous electroencephalography(EEG)found that JME patients’ brain showed microscopic structural changes and the changes of functional connectivity(FC)in the brain,but its pathogenesis remains controversial.In order to further understanding the pathogenesis of JME,we used the resting state functional magnetic resonance imaging(fMRI)to study the brain structure and functional connectivity of patients with juvenile myoclonic epilepsy.Methods : Using high-resolution MRI t1-weighted and resting-state functional magnetic resonance imaging(fMRI)to obtain the brain data from 25 patients with JME and 24 cases of healthy controls.First of all,through the voxel-based morphometry(VBM)analysis,we obtained a set of gray matter volume(GMV)which showed difference from the control group,and then the changed gray matter volume area as the seed point to connecting the whole brain voxel by functional connectivity analysis.Finally,the observed changes of structure and FCs performance the correlation analysis with the clinical features(onset of age and the duration of the disease).Result : The findings of voxel-based morphometry analysis: The decreased GMV regions were found in the bilateral cerebellar crus 1 area,the vermis,the right orbital superior frontal gyrus,the left middle temporal gyrus,the left putamen,the right hippocampus,the bilateral caudate and the right thalamus.Functional connectivity analysis which based on the seeds to the whole brain voxel mainly found changes in motor function related areas and cognitive activities related regions,such as the cerebellar-thalami-cortical network,the dorsal attention network(DAN),the salience network(SN),and the default mode network(DMN).At last,through correlation analysis,the changed FCs were related to the clinical features(duration and onset age of the patients)of JME patient,and there were no significantly correlations been found between the changed GMV and the clinical characteristics.Conclusion:We studied the structure and functional connectivity of brain in patients with JME,the mainfindings of the results are as follows: 1)the changed structural of the brain in JME patients,which may cause the change of FC.We found the anterior and posterior part of the cerebellum has increased FC,and the posterior of the cerebellum with the thalamus and basal ganglia region showed increased FC,these results may suggesting that the cerebellum in the role of adjustment in movement appears to be more active,which reflects the enhanced adjustment of cerebellum to the abnormal movement and the cerebellum take part in the feedback adjustment mechanism of movement;In addition,the decrease FC between cerebellum and supplementary motor area indicates the decrease coordination function of cerebellum.2)The increased FC between the cerebellum and occipital lobe may prompt the feedback regulation mechanism of cerebellum(inhibition)inhibit the activities of the occipital lobe,thereby reducing the seizure of photosensitivity epilepsy.3)The decreased GMV of frontal lobe and decreased FC with the cerebellum may suggest the declined cognitive activity of JME patients,which probably due to the damaged nerve cell by the preponderant discharge of the frontal lobe;4)In addition,the changed FC was related with the clinical features of patients with JME.The current observations may contribute to the understanding of the pathogenesis of JME.