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Altered gray matter volume in MRI-negative focal to bilateral tonic–clonic seizures

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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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Authors and Affiliations

  1. Department of Functional Neurosurgery, The Brain Hospital Affiliated to Nanjing Medical University, Nanjing, 210029, China

    Honghao Xu, Haitao Zhu, Lei Luo & Rui Zhang

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  1. Honghao Xu
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  2. Haitao Zhu
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Contributions

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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Correspondence to Rui Zhang.

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Statement of Ethics

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

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