Abstracts

Rationale: Executive deficits and impulsiveness are extensively reported in Juvenile Myoclonic Epilepsy (JME).There are evidences, in some psychiatric disorders, that these deficits, regarded as behavioral inhibition impairments, are moderated by the intelligence. In this study, we evaluated and compared the performance of adults with juvenile myoclonic epilepsy (JME) with higher and average range IQ on tasks for executive functions (EF) and impulsive traits.Methods: We investigated the neuropsychological performance of 61 adults with JME ( 54.1 % women; mean age 26.86 yrs; median 25 yrs; SD 8.14 ; IQR 16-48), compared with 44 healthy controls (56.8% women; mean age 28.09 yrs; median 24.5 yrs; SD 8.99; IQR 18-48) with a comprehensive battery of neuropsychological tests that measure executive/ attentional functioning. Impulsive traits were assessed using the Cloninger’s Temperament and Character Inventory (Novelty Seeking Domain - NS) (Moschetta et al., 2012). Adults with clinical diagnosis of JME were divided into two groups, age and gender-matched, according to their IQ level – GI: IQ > 100— JME group with higher IQ (mean 110.37; median 109;SD 7.96; IQR: 101-127), and GII: IQ < 100—JME group with average range IQ (mean 89.76; median 90; SD 5.06; IQR 82-100).Results: The JME group with higher IQ (GI) presented worse performance compared to controls on five subtests: Digits Span Backwards (0.001); time to completion on Stroop I (0.010) and III (0.035) number of errors on Stroop 3 (0 .002) and; Wisconsin Card-Sorting Test (WCST)— total number of errors (0.021) The JME group with average range IQ (GII) had a worse on executive functioning compared with the control group in 12 subtests: Digits Span Forward (0.004) and Backward (0.009); time to completion of Stroop 1, 2 and 3 (< .001) and number of errors on Stroop 3 (< 0.001); time to completion on TMTA and number of errors on TMTB (< 0.001); Wisconsin Card-Sorting Test (WCST)- categories achieved (0.001), total number of errors (<0.001), total number of incorrect perseverative responses (<0.001) and failure to maintain set (< 0.001). Considering Novelty Seeking, GI had worse performance in NS2 – Impulsivity (0.018) whilst GII had worse performance on NS1-Exploratory Excitability (<0.001), NS2 - Impulsivity (<0.001) and NS total (<0.001) compared with controls.Conclusions: Adults with JME and higher IQ show less evidence of executive functioning deficits compared with those with JME and standard IQ, suggesting that a higher degree of intellectual efficiency may act as a compensatory mechanism. It also minimized some aspects of impulsive traits. Patients with JME and higher cognitive reserve may create strategies to dodge their cognitive obstacles. In this context, intelligence may protect and, at the same time, ”mask"" impairments that could be detected earlier.