Evaluation of cognition, structural, and functional MRI in juvenile myoclonic epilepsy

Roebling, Robert; Scheerer, Nico; Uttner, Ingo; Gruber, Oliver; Kraft, Eduard; Lerche, Holger

doi:10.1111/j.1528-1167.2009.02127.x

Cited by 85 publications

(88 citation statements)

References 40 publications

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“…The long-held belief that idiopathic epilepsies do not present with cognitive deficits has been contradicted by evidence that patients with JME have specific cognitive dysfunctions, mainly in functions related to the frontal lobes [2][3][4][5][6][7][8][9].…”

Section: Introductionmentioning

confidence: 97%

Juvenile myoclonic epilepsy: The impact of clinical variables and psychiatric disorders on executive profile assessed with a comprehensive neuropsychological battery

Moschetta

Valente

2012

Epilepsy & Behavior

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Executive dysfunction is reported in juvenile myoclonic epilepsy (JME). However, batteries employed in previous studies included no more than three tests of executive function. In this study, we aimed to assess executive and attentional functions in JME using a comprehensive battery of eight tests (encompassing fifteen subtests). We also evaluated neuropsychological profiles using a clinical criterion of severity and correlated these findings with epilepsy clinical variables and the presence of psychiatric disorders. We prospectively evaluated 42 patients with JME and a matched control group with Digit Span tests (forward and backward), Stroop Color-Word Test, Trail Making Test, Wisconsin Card-Sorting Test, Matching Familiar Figures Test and Word Fluency Test. We estimated IQ with the Matrix Reasoning and Vocabulary subtests of the Wechsler Abbreviated Intelligence Scale. The patients with JME showed specific deficits in working memory, inhibitory control, concept formation, goal maintenance, mental flexibility, and verbal fluency. We observed attentional deficits in processes such as alertness and attention span and those requiring sustained and divided attention. We found that 83.33% of the patients had moderate or severe executive dysfunction. In addition, attentional and executive impairment was correlated with higher frequency of seizures and the presence of psychiatric disorders. Furthermore, executive dysfunction correlated with a longer duration of epilepsy. Our findings indicate the need for comprehensive neuropsychological batteries in patients with JME, in order to provide a more extensive evaluation of attentional and executive functions and to show that some relevant deficits have been overlooked.

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Section: Introductionmentioning

confidence: 97%

Juvenile myoclonic epilepsy: The impact of clinical variables and psychiatric disorders on executive profile assessed with a comprehensive neuropsychological battery

Moschetta

Valente

2012

Epilepsy & Behavior

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“…[7][8][9][10] JME is also characterized by the absence of detectable structural brain abnormalities using MRI or CT. 11 Focal abnormalities have been detected using volumetry or automated voxel-based morphometry (VBM) of structural MRI scans. 12 These changes, however, have shown marked spatial variability, 13 albeit with a tendency toward changes in frontal cortex. [14][15][16] This frontal emphasis has…”

mentioning

confidence: 99%

Focal structural changes and cognitive dysfunction in juvenile myoclonic epilepsy

O’Muircheartaigh¹,

Vollmar²,

Barker³

et al. 2011

Neurology

152

148

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Objective: The aim of this study was to determine if there were focal cortical abnormalities in juvenile myoclonic epilepsy (JME) using neuropsychological investigations and MRI. Methods:Twenty-eight patients with JME and a large sample of healthy controls were assessed using a series of neuropsychological tests as well as structural and diffusion tensor MRI (DTI). DTI measures assessed fractional anisotropy (FA) within a white matter skeleton.Results: Neuropsychological testing indicated subtle dysfunctions in verbal fluency, comprehension, and expression, as well as nonverbal memory and mental flexibility. Utilizing whole-brain voxel-based morphometry for gray matter MRI data and tract-based spatial statistics for white matter diffusion MRI data, we found reductions in gray matter volume (GMV) in the supplementary motor area and posterior cingulate cortex and reductions in FA in underlying white matter of the corpus callosum. Supplementary motor area FA predicted scores in word naming tasks and expression scores. Posterior cingulate cortex GMV and FA predicted cognitive inhibition scores on the mental flexibility task. Conclusions:The neuropsychological, structural, and tractography results implicate mesial frontal cortex, especially the supplementary motor area, and posterior cingulate cortex in JME. Juvenile myoclonic epilepsy (JME) is a common type of idiopathic generalized epilepsy (IGE), accounting for approximately 4%-11% of all epilepsies. It is characterized by an age-specific onset of epilepsy with myoclonic jerks, generalized tonic-clonic seizures, and, less frequently, absences. 1A typical abnormality detected by EEG is bilateral spike or polyspike and wave complexes, often strongest in frontocentral areas.2 Further focal or asymmetric abnormalities on EEG occur in approximately 30% of patients. 3,4 Fifty years ago patients with JME were noted to have personality traits previously considered to characterize frontal lobe pathology.5 Studies examining neuropsychological aspects have identified a range of deficits, for example impaired performance on tasks of mental flexibility and cognitive speed. 6 More recently, further impairments in executive functions have been highlighted. 7-10

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“…99,100 In contrast to focal epilepsy, patients with juvenile myoclonic epilepsy (JME) do not show a difference in working memory-related BOLD network compared with controls. 101 …”

Section: Applications Of Bold Fmri and Dti In Epilepsymentioning

confidence: 97%

Applications of Blood-Oxygen-Level-Dependent Functional Magnetic Resonance Imaging and Diffusion Tensor Imaging in Epilepsy

Chaudhary

Duncan

2014

Neuroimaging Clinics of North America

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Evaluation of cognition, structural, and functional MRI in juvenile myoclonic epilepsy

Cited by 85 publications

References 40 publications

Juvenile myoclonic epilepsy: The impact of clinical variables and psychiatric disorders on executive profile assessed with a comprehensive neuropsychological battery

Juvenile myoclonic epilepsy: The impact of clinical variables and psychiatric disorders on executive profile assessed with a comprehensive neuropsychological battery

Focal structural changes and cognitive dysfunction in juvenile myoclonic epilepsy

Applications of Blood-Oxygen-Level-Dependent Functional Magnetic Resonance Imaging and Diffusion Tensor Imaging in Epilepsy

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