A meta-analysis of voxel-based morphometry studies on gray matter volume alteration in juvenile myoclonic epilepsy.

The findings of structural neuroimaging studies on gray matter volume (GMV) of juvenile myoclonic epilepsy (JME) with voxel-based morphometry (VBM) were inconsistent. We aim to evaluate consistent gray matter changes in JME quantitatively. A systematic review of VBM studies on GMV of patients with JME and healthy control (HC) subjects indexed in PubMed and EMBASE from January 1990 to June 2012 was conducted. Coordinates were extracted from clusters of significant GMV difference between patients with JME and HC subjects. Meta-analysis was performed using Effect Size Signed Differential Mapping (ES-SDM). Seven studies with a total of 211 JME patients and 241 HC subjects were included in the meta-analysis. Increased GMV were observed in the bilateral medial frontal gyrus and anterior cingulate, whereas decreased GMV in the bilateral thalamus. The findings remain largely unchanged in the jackknife sensitivity analyses. The meta-analysis not only identified consistent changes in some regions of gray matter in patients with JME, but also supports the notion of thalamocortical circuitry involved in the pathogenesis of JME.