Authors :
Maria Luisa M N. Paiva, University of Sao Paulo (USP); Ellen Marise Lima, University of Sao Paulo (USP); Patricia Rzezak, University of Sao Paulo (USP); Melanie Mendoza, University of Sao Paulo (USP); and Kette D. Valente, University of Sao Paulo (USP)
Rationale: Persons with Juvenile Myoclonic Epilepsy (JME) may have impulsive personality traits, as well as personality disorders related to impulse control [1, 2]. Decision Making (DM) is one aspect of impulsivity and represents the ability to decide between two or more options in a given situation. There are at least two domains of DM: under ambiguity and under risk [3]. To the moment, there is no data comparing these two domains of DM in patients with JME. Therefore, we evaluated DM dimensions in JME and its correlation with epilepsy-related factors. Methods: We evaluated 35 patients with JME (62.86% female, mean age 27.9 years/ SD ± 8.97) and 39 age and gender matched health subjects (48.72% female; mean age 28.9 years/ SD ± 10.2) with the GDT (DM under risk) and IGT (DM under ambiguity). The estimated IQ score was obtained from subtests of the Wechsler Adult Intelligence Scale (WAIS-III). Statistical standard procedures were carried out with IBM SPSS Statistics. For all statistical analyzes, an a value of 0.05 was used, with a confidence interval of 95%. Results: In GDT, patients with JME had a higher number of risky choices (p= 0.011), lower number of safe choices (p = 0.011), and lower GDT NET score (p= 0.007) compared to controls. There was no significant difference between groups in IGT block A (p= 0.713), IGT block B (p= 0.401), IGT block C (p= 0.371), IGT block D (p= 0.165) and IGT NET score (p= 0.286). However, patients with higher frequency of GTC (p= 0.028) and absence seizures (p= 0.005) had worse performance in IGT block choices. Intragroup and intergroup analysis showed no significant difference between IQ stratas for all GDT and IGT categories. However, learning slope obtained from deck changes in IGT block choices showed a random pattern of decision making for all patients and controls with lower IQ. Conclusions: Patients with JME showed difficulty in developing and maintaining an advantageous decision strategy across time, for both risky and ambiguous situations. Patients with JME and higher IQ have better performance in this domain that is probably associated with the learning process throughout the test. On the other had, patients with drug-resistant JME had worse performance on decision making under ambiguity. These findings emphasize that there are distinct phenotypes in JME. Funding: CAPES – Coordination of Improvement of graduation and postgraduationFAPESP - Research Support Foundation of the State of São Paulo