Juvenile Myoclonic Epilepsy with Frontal Executive Dysfunction is Associated with Reduced Gray Matter Volume by Voxel-based Morphometry

OBJECTIVE: Frontal executive dysfunction (FED) and abnormalities in volumetric magnetic resonance imaging (MRI) have been described in juvenile myoclonic epilepsy (JME). We aimed to compare JME patients with and without FED by group analysis of voxel-based morphometric (VBM) estimates of brain volume in MRI. SUBJECTS AND METHODS: We studied frontal executive functions in patients with JME and analyzed the possible association of FED with their demographic, clinical, and electrographic characteristics. We aimed to do group analysis of the VBM MRI brain data to compare the gray matter (GM) volumes of JME patients with and without FED. RESULTS: We recruited 34 patients (20 women) with JME (mean age 23.7 ± 4.58 years) from the epilepsy outpatient services. FED was detected in twenty patients (58.8%). Group analysis of VBM MRI brain showed significant (P < 0.001) reduction in GM volume in dorsolateral prefrontal cortex (left Brodmann area [BA] 10, 46, 9, Z-score 3.36, 2.91, 2.03, respectively, and right BA 10 and BA 45, Z-score 2.98 and 3.36, respectively), left insula (BA 13, Z-score 2.14), temporal lobe (BA 38, Z-score 2.76), in the subgroup of JME with FED. INFERENCE: JME with FED has an anatomical correlate in the form of reduced GM volume in dorsolateral prefrontal cortex.