J Pediatr Epilepsy 2018; 07(01): 014-020
DOI: 10.1055/s-0038-1637731
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Thalamocortical Tracts, but not the Putamen, Present Microstructural Abnormalities in Juvenile Myoclonic Epilepsy: A Diffusion Tractography Study

Eman H. Esmail
Department of Neurology, Cairo University, Giza, Egypt
Hadeel M. Seif El Dein
Department of Radiology, Pediatric University Hospital, Cairo University, Giza, Egypt
Inas A. Yassine
Department of Systems and Biomedical Engineering, Cairo University, Giza, Egypt
Center for Informatics Science, Nile University, Giza, Egypt
Rania Zakaria
Department of Radiology, Pediatric University Hospital, Cairo University, Giza, Egypt
› Author Affiliations
Funding This is an academic research study performed using the facilities of the institution. Grants or funding were not received for this work.
Further Information

Publication History

20 July 2017

13 February 2018

Publication Date:
31 March 2018 (eFirst)


Background and Purpose The pathology of juvenile myoclonic epilepsy (JME) is related to thalamocortical dysfunction, and the putamen is closely related to the thalamocortical circuit. The purpose of this study is to evaluate the microstructure of the thalamo-cortico-striatal circuit in JME patients using diffusion tensor imaging (DTI).

Materials and Methods This case–control study was conducted on 13 patients with JME (10 females and 3 males with a mean age of 23.38 ± 4.75 years) and 9 age- and sex-matched volunteers as control subjects. All subjects underwent DTI and conventional magnetic resonance imaging. The data were then processed via denoising, registration, and segmentation of the internal capsule and right and left putamen using the FMRIB Software Library (FSL). The FSL was also used to calculate the different anisotropy measures: the fractional anisotropy (FA), mean diffusivity (MD), longitudinal diffusivity (LD), and radial diffusivity (RD).

Results The patients with JME had lower FA and higher LD in the thalamocortical tracts and lower MD in the frontal corticospinal tracts than the control subjects (p = 0.014, 0.001, and 0.04, respectively). No other significant differences were detected between the patients with JME and control subjects. The values measured in the right putamen were not significantly different from those measured in the left putamen in either the patients or controls.

Conclusion This study demonstrates that microstructural abnormalities occur in the thalamocortical tracts but not the putamen of patients with JME. Nevertheless, microstructural asymmetry was not observed in the patients with JME.

Authors' Contribution

 1. Eman H. Esmail supervised the clinical data collection, revised the statistical analysis of the results, and participated in writing and revising the results and writing the manuscript.

 2. Hadeel M. Seif El Dien performed all radiological investigations, participated in writing and revising the manuscript, and performed correspondence for publication.

 3. Inas A. Yassine performed image processing and participated in writing and revising the manuscript.

 4. Rania Zakaria supervised the work and revised the manuscript.