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Transcranial brain parenchyma sonography in patients with juvenile myoclonic epilepsy

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Abstract

Introduction

There are rising evidences that subcortical structures, including the basal ganglia, are affected in patients with epilepsy. These structures are thought to influence the modulation and phenotypic expression of epileptic seizures. Our study aimed to evaluate the presence of structural abnormalities in subcortical structures in patients with juvenile myoclonic epilepsy (JME).

Methods

This cross-sectional study included 51 patients who were diagnosed with JME and who were monitored on an outpatient basis at the Clinic for Neurology and Psychiatry for Children and Youth in Belgrade from January 1985 to October 2017. All patients underwent transcranial parenchymal sonography (TCS) from October 2015 to October 2017. Relation of clinical parameters (seizure control andcognitive functioning,) with TCS results was assessed.

Results

Hyperechogenicity of the substantia nigra (SN) was detected in 37.2% of JME subjects and it was significantly more common in patients with JME than in the control group. The marked echogenicity of the red nucleus (RN) was detected in 17.6% of cases, while 11.8% of subjects had hyperechogenic RN. The presence of hyperechogenic RN (both right and left) was significantly more frequent in the group of patients with JME compared to the control group. The third ventricle diameter was larger in patients with JME than in controls.

Conclusion

Structural changes of certain subcortical structures, primarily SN and RN, detected in JME patients indicate additional non-lesional abnormalities of the basal ganglia and midbrain structures in these patients.

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Data availability

The data that support the findings of this study are available upon request from the corresponding author. The data are not publicly available due to concerns regarding the privacy of study participants.

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Acknowledgements

We are deeply grateful to our late Professor Nebojša Jović for his commitment, help and support in this work.

Funding

This work was granted by the Ministry of Science, Technological Development and Innovation of the Republic of Serbia: 451-03-66/2024-03/200110.

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Authors and Affiliations

  1. Clinic for Neurology and Psychiatry for Children and Youth, Belgrade, Serbia

    Ivana Djordjević, Ana Kosać & Dragana Vučinić

  2. University Children’s Hospital, Belgrade, Serbia

    Stefan Djordjević

  3. Faculty of Medicine, University of Belgrade, Belgrade, Serbia

    Stefan Djordjević, Ana Kosać & Milija Mijajlović

  4. Institute for Children’s Diseases, Clinical Center of Montenegro, Podgorica, Montenegro

    Nelica Ivanović Radović

  5. Faculty of Medicine, University of Montenegro, Podgorica, Montenegro

    Nelica Ivanović Radović

  6. University Clinical Center of Serbia, Neurology Clinic, 6, Dr Subotica Street, 11000, Belgrade, Serbia

    Mirjana Ždraljević & Milija Mijajlović

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  1. Ivana Djordjević
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  2. Stefan Djordjević
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Contributions

All authors contributed to the study's conception and design. Material preparation, data collection, and analysis were performed by IDJ, SDJ, AK, DV, NIR, and MM. The first draft of the manuscript was written by IDJ and MŽ, MŽ and MM prepared figure 1 and all authors have commented on previous versions of the manuscript. The whole research was conceptualized and supervised by MM. All authors have read and approved the final manuscript.

Corresponding author

Correspondence to Milija Mijajlović.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The study was approved by the Ethic Committee of the Clinic for Neurology and Psychiatry for Children and Youth in Belgrade (CNPCY 11/I-15).

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Written informed consent was obtained from all participants or their parents/caregivers.

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Djordjević, I., Djordjević, S., Kosać, A. et al. Transcranial brain parenchyma sonography in patients with juvenile myoclonic epilepsy. Acta Neurol Belg (2024). https://doi.org/10.1007/s13760-024-02561-6

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