Morphological analysis of cerebellum lobules in patients with generalized epilepsy

Objective: The main reason of excessive discharge in cortical neurons occurring in generalized epilepsy is not fully known. The cerebellum is a structure with prominent inhibitory effects. Based on the hypothesis that volumetric losses that may occur in the cerebellum in generalized epilepsy may be effective in the formation mechanism of respective discharges; our study aimed to evaluate the cerebellum lobules of patients with generalized epilepsy in detail. Method: We conducted our study on magnetic resonance images in T1 MP-RAGE sequences obtained retrospectively from 40 patients with generalized epilepsy (20 males, 20 females) and 40 healthy individuals (20 males, 20 females) aged between 49 and 79. The volume of the cerebellum lobules was calculated using the VolBrain software which is an automatic segmentation program. In addition to volume calculations, results were visualized in 3D with the ITK-SNAP software. Results: Statistically, cerebellum volumes of patients with generalized epilepsy were significantly smaller than those of the control group (p<0.05). Similarly, according to the lobular analysis of the cerebellum, the volumes of lobule III, lobule IV, lobule VIIA (lobule crus I and lobule crus II), lobule VIIIA, lobule VIIIB, lobule IX and lobule X were significantly smaller in patients with generalized epilepsy than in the control group (p<0.05). Conclusion: According to the results of our study, cerebellum volumes were found to be smaller in patients with generalized epilepsy than in the control group. The decrease seen in the volume of the cerebellum supports the hypothesis of our study. Key words: generalized epilepsy, cerebellum, volume, 3D evaluation, cerebellum morphology