Research On The Structural Network Of Brain White Matter In Newly Diagnosed Juvenile Myoclonic Epilepsy

Objective : Based on diffusion tensor imaging technology and graph theory analysis method,we aimed to study the topological properties of cerebral white matter structural network in newly diagnosed juvenile myoclonic epilepsy patients,and explore the pathophysiological mechanism of JME from the level of structural network.Methods: Twenty-five newly diagnosed JME patients and twenty-eight healthy controls with sex and age matching were enrolled.Deterministic fiber bundle tracing imaging analysis was performed on the diffusion tensor imaging data of all subjects,and the structural connection network was constructed using anisotropic fraction values as edge weights.The global topology attributes,node attributes,network connections and rich club attributes of the structural network were calculated by using graph theory analysis methods.The differences of network parameters between groups were compared,and the correlation between abnormal network parameters and clinical course of JME patients was analyzed.Results:（1）In global properties,the global efficiency and local efficiency of the structural network of the brain in JME patients decreased compared with the HC group,and the characteristic path length increased;（2）In local areas,the nodal efficiency of six brain regions was significantly lower in JME patients compared with the HC group,including the right precentral gyrus,right dorsolateral superior frontal gyrus,right posterior cingulate gyrus,right caudate nucleus,and bilateral middle frontal gyrus.The nodal efficiency and degree centrality of the right posterior cingulate gyrus were significantly reduced;（3）JME patients had a subnetwork with enhanced connectivity,involving brain regions including the left paracentral lobule,right middle frontal gyrus,right dorsolateral superior frontal gyrus,right precentral gyrus,right subinsular frontal gyrus and right orbitofrontal gyrus;（4）Compared with the HC group,the strength and density of rich club connections were significantly lower in JME patients.Conclusions: Newly diagnosed JME patients had global and local abnormalities in the white matter structural network of the brain,with reduced global integration capacity and information transfer efficiency and impaired core organization connectivity,resulting in abnormal network information interaction,which is hypothesized to be a possible brain network mechanism for cognitive deficits in JME patients.Some important network nodes and pathological networks such as frontal cortices basal ganglia and default network were changed.These change patterns may provide some research ideas and directions for the pathophysiological mechanism and therapeutic intervention strategies of JME.