Abstracts

Rationale: Studies demonstrate that patients with Juvenile Myoclonic Epilepsy (JME) have executive impairments. In addition, cluster B personality disorder has been reported in 20-30% when using the categorial classification of DSM-IV, corroborating the hypothesis of a frontal lobe deficit. To moment, there are no studies on personality traits as well as its correlation with executive dysfunction and clinical response to AED. This study aimed to: 1. verify executive/attentional d ficits in patients with with JME with an extensive neuropsychological battery; 2. determine the severity of the attentional/executive d ficit; 3. verify personality traits with a valid instrument; 4. correlate performance on executive/attentional tests with expression of personality traits and clinical variables of epilepsy. Methods: Forty-two patients with JME were evaluated by: i. comprehensive battery for executive and attentional functions; ii. Assesment of personality based on a questionnaire for evaluation of personality traits (TCI) and compared to 42 healthy controls, with no psychiatric and neurological diagnosis, matched by age, gender and social-economic status. Results: Patients with JME had worse performance than controls on tests that evaluate immediate attention, mental control, selective and sustained attention, mental flexibility, inhibitory control, verbal fluency, concept formation, goal maintenance, and verbal short-term memory. Based on clinical criteria, 83,33% had severe to moderate executive dysfunction. Patients with JME presented higher expressions of impulsive personality traits compared to controls. Executive/attentional dysfunction was correlated with worse impulse control. There was a positive correlation between seizure frequency and the presence of psychiatric disorders, worse executive/attentional deficits and higher expression of impulsive traits. Longer duration of epilepsy and early age of onset were correlated with executive dysfunction and impulsive personality traits, respectively. The categorical analysis between groups of easy and hard to control-epilepsy showed that refractory patients had worse executive dysfunction and higher impulsive traits. Conclusions: Our study demonstrates the presence of executive dysfunction and impulsive personality traits in patients with JME. In addition, we verified the existence of two distinctive groups of patients, being refractory JME patients were more globally impaired. These findings indicate the necessity of a better phenotypic characterization of patients with JME in order to include clinical endophenotypes. This work was supported by: FAPESP/CNPQ.