{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T16:17:16Z","timestamp":1792081036521,"version":"4.4.0"},"reference-count":40,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2014,6,5]],"date-time":"2014-06-05T00:00:00Z","timestamp":1401926400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Epilepsia"],"published-print":{"date-parts":[[2014,7]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Juvenile myoclonic epilepsy (<jats:styled-content style=\"fixed-case\">JME<\/jats:styled-content>) has been considered to be a frontal variant of thalamocortical network dysfunction in epilepsy. Changes of \u03b3\u2010aminobutyric acid (<jats:styled-content style=\"fixed-case\">GABA)<\/jats:styled-content>ergic neurotransmission may play a key role in this dysfunction. Magnetic resonance spectroscopy (MRS) is the only noninvasive method to measure <jats:styled-content style=\"fixed-case\">GABA<\/jats:styled-content> concentrations in different brain regions. We measured <jats:styled-content style=\"fixed-case\">GABA<\/jats:styled-content> and other metabolite concentrations in the thalamus and frontal lobe of patients with <jats:styled-content style=\"fixed-case\">JME<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A specific protocol was used for determining <jats:styled-content style=\"fixed-case\">GABA<\/jats:styled-content> concentrations in the thalamus, frontal lobe, and motor cortex contralateral to the handedness in 15 patients with <jats:styled-content style=\"fixed-case\">JME<\/jats:styled-content> and 15 age\u2010matched controls. In addition, we measured concentrations of glutamate and glutamine, <jats:italic>N<\/jats:italic>\u2010acetyl\u2010aspartate (<jats:styled-content style=\"fixed-case\">NAA<\/jats:styled-content>), myoinositol, creatine, and choline using MRS with short echo time. <jats:styled-content style=\"fixed-case\">JME<\/jats:styled-content>\u2010related concentration changes were analyzed comparing patients to controls, also considering potential effects of antiepileptic drugs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In patients with JME, <jats:styled-content style=\"fixed-case\">GABA<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">NAA<\/jats:styled-content> were reduced in the thalamus (p\u00a0=\u00a00.03 and p\u00a0=\u00a00.02), whereas frontal <jats:styled-content style=\"fixed-case\">GABA<\/jats:styled-content> and glutamine were elevated (p\u00a0=\u00a00.046 and p\u00a0=\u00a00.03). <jats:styled-content style=\"fixed-case\">MRS<\/jats:styled-content> revealed reduced <jats:styled-content style=\"fixed-case\">NAA<\/jats:styled-content> in the thalamic gray matter contralateral to the handedness (p\u00a0=\u00a00.04 each). These changes were found consistently in patients treated with new antiepileptic drugs and with valproate, although the extent of metabolic changes differed between these treatments.<\/jats:p><\/jats:sec><jats:sec><jats:title>Significance<\/jats:title><jats:p>Decreased thalamic and increased frontal <jats:styled-content style=\"fixed-case\">GABA<\/jats:styled-content> suggest a dysfunction of <jats:styled-content style=\"fixed-case\">GABA<\/jats:styled-content>ergic neurotransmission in these brain regions of  patients with JME. The <jats:styled-content style=\"fixed-case\">NAA<\/jats:styled-content> decrease in the gray matter of the thalamus may hint to a damage of <jats:styled-content style=\"fixed-case\">GABA<\/jats:styled-content>ergic neurons, whereas frontal increase of <jats:styled-content style=\"fixed-case\">GABA<\/jats:styled-content> and its precursor glutamine may reflect increased density in <jats:styled-content style=\"fixed-case\">GABA<\/jats:styled-content>ergic neurons due to subtle cortical disorganization in the thalamofrontal network.<\/jats:p><jats:p>A PowerPoint slide summarizing this article is available for download in the Supporting Information section <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/epi.12656\/suppinfo\">here<\/jats:ext-link>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/epi.12656","type":"journal-article","created":{"date-parts":[[2014,6,5]],"date-time":"2014-06-05T20:47:51Z","timestamp":1402001271000},"page":"1030-1037","source":"Crossref","is-referenced-by-count":51,"title":["Frontal and thalamic changes of <scp>GABA<\/scp> concentration indicate dysfunction of thalamofrontal networks in juvenile myoclonic epilepsy"],"prefix":"10.1111","volume":"55","author":[{"given":"Elke","family":"Hattingen","sequence":"first","affiliation":[{"name":"Department of Neuroradiology Goethe University Frankfurt Frankfurt Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"L\u00fcckerath","sequence":"additional","affiliation":[{"name":"Department of Neuroradiology Goethe University Frankfurt Frankfurt 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