Abstract
To investigate cortical changes in MRI-negative patients with focal to bilateral tonic–clonic seizures (FBTCS). High-resolution three-dimensional T1-weighted MRI were collected with a GE 3.0-T MRI scanner from 26 patients with FBTCS and 21 healthy volunteers at Nanjing Brain Hospital. Voxel-based morphometry was performed on T1-weighted MRI of all subjects. A two-sample t test was performed to compare the GMV of two groups. Age and gender were taken as covariables, so that brain regions with significant differences, as compared by two-sample t test, between the two group were obtained. These regions were extracted as the regions of interest (ROIs) used for correlation analysis between ROIs and clinical variables. There is no significant difference in GMF between two groups. In FBTCS, regions with decreased GMV are bilateral thalamus, bilateral orbitofrontal cortex, left medical cingulate gyrus, and right supplementary motor area. GMV is increased within the bilateral para-hippocampal regions (voxel-wise FDR-corrected, P < 0.05). The GMVs are significantly negatively correlated with disease duration in the left thalamus and the left para-hippocampal region (P < 0.05). Seizures may lead to the loss of neurons and the decrease of GMV in FBTCS. The increase of GMV in some regions might be due to inflammatory responses in the early stages of epileptic seizures.
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Abbreviations
- CSF:
-
Cerebrospinal fluid volume
- EEG:
-
Electroencephalogram
- FBTCS:
-
Focal to bilateral tonic–clonic seizures
- FDR:
-
False discovery rate
- FOV:
-
Field of view
- GMF:
-
Gray matter fraction
- GMV:
-
Grey matter volume
- HC:
-
Healthy control
- MNI:
-
Montreal Neurological Institute
- MRI:
-
Magnetic resonance imaging
- ROI:
-
Regions of interest
- SMA:
-
Supplementary motor area
- TE:
-
Echo time
- TI:
-
Inversion time
- TIV:
-
Total intracranial volume
- TR:
-
Repetition time
- VBM:
-
Voxel-based morphological
- WMV:
-
White matter volume
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Acknowledgements
This study is supported by Grants from Nanjing medical science and technology development project (Grant no. YKK17136 to Haitao Zhu).
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HX and HZ participated to an equal extent in planning, analyzing, evaluating, and writing the paper, and should be considered as co-first authors.
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All subjects were informed and signed the study consent form. This study was approved by the Ethics Committee of Brain Hospital Affiliated to Nanjing Medical University.
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Xu, H., Zhu, H., Luo, L. et al. Altered gray matter volume in MRI-negative focal to bilateral tonic–clonic seizures. Acta Neurol Belg 121, 1525–1533 (2021). https://doi.org/10.1007/s13760-020-01383-6
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DOI: https://doi.org/10.1007/s13760-020-01383-6