Study On The Brain Function Network Of Newly Diagnosed Juvenile Myoclonic Epilepsy

Objective: Studies have shown that juvenile myoclonic epilepsy(JME)has abnormal brain network.In this study,by comparing the large-scale brain functional network of newly diagnosed juvenile myoclonic epilepsy patients with the healthy control group,the changes of brain functional network in JME patients were explored,and the pathophysiological mechanism of JME was revealed to a certain extent in combination with the clinical characteristics of JME.Methods: T1-weighted images,T2-weighted images and RS-fMRI images were collected from 26 newly diagnosed juvenile myoclonic epilepsy patients and 22 healthy controls matched in age and sex.After data preprocessing removed some subjects that could not be further processed,functional MRI data of 20 JME patients and 21 healthy controls were finally included.A large-scale brain function network was constructed according to the brain network atlas 246 template proposed by the Institute of Automation of the Chinese Academy of Sciences,and the network analysis method of graph theory was used to study the network characteristics and node characteristics changes of the brain functional network of JME patients(Including clustering coefficient,characteristic path length,small-world attribute,global and local efficiency,node efficiency,and connectivity strength of network edge).Results: The functional network topology characteristics of JME have changed.Compared with the control group,the node efficiency of JME group at 6 nodes was significantly different.The regions with increased node efficiency include A6cdl_R(dorsal caudal area of right premotor cortex)and A4ul_R(upper limb representative area of right primary motor cortex).Node efficiency decreased in A38l_L +A38m_L(left medial temporal pole),A38m_R(right medial temporal pole),and A44V_L(left ventral area pars opercularis).No significant difference was found in the local and global efficiency,characteristic path length,small-world attribute and clusteringcoefficient of the two groups of brain functional networks.In addition,network-based statistics(NBS)were applied to examine the difference in the connectivity strength between the two groups.Compared with the control group,JME patients had 12 edges with reduced functional connectivity strength and no edges with increased functional connectivity strength.JME feature connection weakened edges include:A9/46v_R—TE1.0/TE1.2_L(right ventral dorsolateral prefrontal cortex to the left superior temporal gyrus),IFS_L—TE1.0/TE1.2_L(the left frontal groove to the left superior temporal gyrus),A9m_L—A22r_R(the left medial dorsolateral prefrontal cortex to the right superior temporal gyrus rostral area),A4ul_R—A21c_R(the right side of upper limb on behalf of the primary motor cortex area to the right temporal caudal area),A10l_R—A2_R(the right frontopolar lateral area to the right somatosensory cortex),A4tl_L—G_L(the left primary motor cortex tongue and larynx region to the left insula),A20iv_L—rLinG_R(the left ventral inferior temporal gyrus to the right rostral lingual gyrus),A32sg_L—lAmyg_L(the left dorsal anterior cingulate cortex subgenual area to the left amygdala lateral),G_L—vmPu_L(the left insula to the left ventromedial putamen),G-L—dlPu_L(the left insula to return to left dorsolateral putamen),dIg_L—dlPu_L(the left dorsal granular insula to the left dorsolateral putamen),A4tl_L—cTtha_R(the left primary potor cortex tongue and larynx region to right caudal temporal thalamus).Conclusions: The increased importance of the motor-related cortex in the functional network of the brain in newly diagnosed JME patients implies recombination of the central nodes of the network,which may be the pathophysiological basis of myoclonic seizures in JME patients.At the same time,in newly diagnosed JME patients,the functional connections between multiple resting state networks,such as the dorsolateral attention network and default mode network,have been changed,suggesting that the existence of extensive brain functional network abnormalities in JME patients may be the reason for the complex clinical manifestations.In summary,large-scale brain functional network study further demonstrate that JME is a generalized epilepsy with “local” abnormalities.