Sun Jung Han

Cortical thickness abnormality in juvenile myoclonic epilepsy

Previous studies on gray matter concentration changes in patients with juvenile myoclonic epilepsy (JME) are inconsistent. To investigate cortical abnormality in JME differently, we measured the cortical thickness in 19 JME patients and 18 normal controls. Results showed that the cortical thicknesses of superior/middle/medial frontal gyri, and superior/middle/ inferior temporal gyri were decreased in JME patients. Moreover, cortical thicknesses of precentral gyrus and medial orbital gyrus of right hemispheres were negatively correlated with disease duration. These findings suggest that JME brains have cortical gray matter atrophy in the frontal and temporal lobes.

CBF changes in drug naive juvenile myoclonic epilepsy patients.

PurposeThe role of thalamus and brainstem in generalized epilepsy has been suggested in previous studies. The aim of the present study was to assess regional cerebral blood flow (rCBF) abnormality in juvenile myoclonic epilepsy (JME) patients.Methods99mTc-ethylcysteinate dimer brain single photon emission computed tomography (SPECT) was performed in 19 drug naive JME patients and 25 normal controls with the similar age and gender distribution. Differences of rCBF between a JME group and a normal control group were examined by the statistical parametric mapping of brain SPECT images using independent t test. The regression analyses in SPM were also performed between rCBF and the age of seizure onset or the disease duration in JME group.ResultsCompared to normal controls, the JME group showed a significant rCBF reduction in bilateral thalami, red nucleus, midbrain, pons, left hippocampus, and in the cerebelli (FDR corrected p < 0.01) whereas rCBF increase in the left superior frontal gyrus (uncorrected p < 0.001 but FDR corrected p > 0.05). Disease duration was negatively correlated with rCBF in bilateral frontal cortices, caudate nuclei, brainstem and cerebellar tonsils.ConclusionsOur results suggest that abnormal neural networks in the thalamus, hippocampus, brainstem and cerebellum are associated with JME.

Can pentobarbital replace amobarbital in the Wada test

To investigate the usefulness of pentobarbital (PTB) in the Wada test, 32 patients injected with PTB and 28 patients injected with amobarbital (AMB) were retrospectively analyzed. The AMB and PTB groups did not significantly differ with respect to mean time for recovery to grade III or V motor activity and duration of EEG delta slowing. The incidence of drowsiness or confusion after injection was lower in the PTB group (P=0.043). Language lateralization was well established in both groups. Fifty-three percent of patients in the PTB group and 46.2% in the AMB group with unilateral temporal lobe epilepsy had memory dominance in the nonepileptic hemisphere. The usefulness of PTB in terms of language and memory lateralization was found to be equivalent to that of AMB. Moreover, PTB produced drowsiness and confusion less frequently than AMB, although one patient in the PTB group experienced transient respiratory depression without any sequelae.

The Effect of Ropinirole on the Quality of Life in Patients with Restless Legs Syndrome in Korea: An 8-Week, Multicenter, Prospective Study

Background and Purpose Dopamine agonists are first-line drugs for treating the symptoms of restless legs syndrome (RLS). However, few studies have investigated the effect of dopamine agonists on the quality of life (QoL) in RLS patients. We conducted a study to determine whether ropinirole exerts positive effects on the QoL in RLS patients and to analyze the underlying factors. Methods Primary RLS patients from eight medical centers were recruited in the study. They were evaluated in the baseline phase using various questionnaires including the Korean versions of the International Restless Legs Scale (K-IRLS), RLS QoL questionnaire (K-RLSQoL), and the Short Form 36 Health Survey (SF-36). After taking ropinirole for 8 weeks the same questionnaires were again completed as a re-evaluation. We analyzed the statistical difference using a paired t-test, a Pearsons correlation, and a stepwise multiple regression in order to identify the factors associated with the QoL change. Results A total of 107 subjects, including 65 (60.7%) females, completed this study. They were aged 51.68±14.80 years (mean±SD) and had a symptom duration of 8.8±9.0 months. After treatment with ropinirole, there were significant improvements on the K-RLSQoL, SF-36, and K-IRLS. The Pearsons correlation analysis showed that the improvement of QoL in RLS patients was significantly correlated with the severity of RLS (r=0.236, p<0.014) at baseline. Conclusions The results from this study suggest that treatment with ropinirole can improve the QoL in RLS patients. The improvement in the QoL is more related with the improvement of RLS symptoms.