Proton magnetic resonance spectroscopy in juvenile myoclonic epilepsy: A systematic review and meta-analysis

Abstract

Purpose: We sought to systematically review and perform a meta-analysis of the magnetic resonance spectroscopy (MRS) findings regarding juvenile myoclonic epilepsy (JME).

Methods: We searched for studies in the PubMed, Web of Science, and Embase electronic databases. Two authors collected articles and extracted data independently. A meta-analysis was performed for diverse metabolites in different brain areas. The mean difference (MD) and 95% confidence interval (CI) were used to compare continuous variables.

Results: A decreased NAA/Cr was observed in the motor cortex (MD=0.14, 95%CI=0.09 to 0.20), and the NAA was reduced in the thalamus (MD=0.74, 95%CI=0.37 to 1.10) and the frontal lobe (MD=0.87, 95%CI=0.45 to 1.28); the GLX/Cr was increased in the insula (MD=-0.10, 95%CI=-0.14 to -0.06) and the striatum (MD=-0.11, 95%CI=-0.17 to -0.05).

Conclusions: JME may be a multi-regional, thalamo-frontal network epilepsy rather than an idiopathic generalized epilepsy syndrome.