Abstracts

The role of thalamus and brainstem in generalized epilepsy has been suggested in previous studies. But decisive evidences have not been demonstrated in human generalized epilepsy. We investigated the interictal abnormality of regional cerebral blood flow (rCBF) in juvenile myoclonic epilepsy (JME) patients. ^99mTc-ethylcysteinate dimer brain single photon emission computed tomography (SPECT) was performed in 19 drug naive JME patients and 25 age, sex-matched normal controls. All patients showed normal brain MRI and myoclonic jerks with rare generalized tonic clonic seizures. Differences of rCBF between a JME group and a normal control group were mapped by statistical parametric mapping of brain SPECT images and we tested interstructural correlations of rCBF in both groups. The regression analyses in SPM were performed between rCBF and the age of seizure onset or the disease duration in JME group. In all SPM analyses, the height threshold was considered to be significant at the level of false discovery rate (FDR) corrected [italic]p[/italic] [lt] 0.05 (corrected for whole brain), the extent threshold was set to [italic]k[/italic][sub]E [/sub][gt] 125. rCBF significantly decreased in bilateral thalami, red nucleus, substantia nigra, superior colliculus, pons (raphe nuclei), and in the cerebellums of JME patients. Furthermore, the normal correlation of rCBF between pons and thalamus was disrupted in JME group. Disease duration was negatively correlated with rCBF in bilateral frontal cortices, caudate nuclei, brainstem and cerebellar tonsils. These results suggest that abnormal neural networks in the thalamus, brainstem and cerebellum underlie the pathogenesis of JME and rCBF changes may be progressive.[figure1] (Supported by a grant (no. HMP-03-PJ1-PG3-21300-0033) of the Good Health R[amp]D Project, Ministry of Health [amp] Welfare, Republic of Korea.)