Trait impulsivity in Juvenile Myoclonic Epilepsy

Abstract

ObjectiveImpulsivity is a multidimensional construct that can predispose to psychopathology. Meta‐analysis demonstrates an association between response impulsivity and Juvenile Myoclonic Epilepsy (JME), a common genetic generalized epilepsy. Here, we test the hypotheses that trait impulsivity is (i) elevated in JME compared to controls; (ii) moderated by specific seizure characteristics; and (iii) associated with psychiatric adverse effects of antiepileptic drugs (AEDs).Methods322 participants with JME and 126 age and gender‐matched controls completed the Barratt’s Impulsiveness Scale (BIS‐brief) alongside information on seizure history and AED use. We compared group BIS‐brief scores and assessed associations of JME BIS‐brief scores with seizure characteristics and AED adverse effects.ResultsThe mean BIS‐brief score in JME was 18.1 ± 4.4 compared with 16.2 ± 4.1 in controls (P = 0.0007). Elevated impulsivity was associated with male gender (P = 0.027), frequent absence seizures (P = 0.0004) and lack of morning predominance of myoclonus (P = 0.008). High impulsivity significantly increased the odds of a psychiatric adverse event on levetiracetam (P = 0.036), but not any other psychiatric or somatic adverse effects.InterpretationTrait impulsivity is elevated in JME and comparable to scores in personality and neurotic disorders. Increased seizure frequency and absence of circadian seizure pattern moderate BIS score, suggesting disruption of both cortico‐striatal and thalamocortical networks as a shared mechanism between seizures and impulsivity in JME. These findings warrant consideration of impulsivity as a distinct target of intervention, and as a stratifying factor for AED treatment in JME, and perhaps other types of epilepsy. The role of impulsivity in treatment adherence and psychosocial outcome requires further investigation.

The burden of disease of idiopathic/genetic generalized epilepsy – A nationwide online survey

“…The BIS-8 score of 17.3 both cohorts was within the range of previous studies on patients with IGE (Fig. 3A) [25,27] and higher than that of healthy population (healthy Danish individuals: BIS-11: 58.6 [24] corresponding to a BIS-8 of 15.0 [25]).…”

“…The difference in BIS-8 and SAPAS-AV scores between patients with and without seizures in the last year did not reach statistical significance. Broader inclusion criteria, different statistical approaches, and a lower sample size are obvious explanations, and we therefore do not think that the results found were conflicting other publications [25].…”

“…Normal Danish values published in [26] are given as comparison. (B) The mean BIS-8 score with a 95% confidence interval for patients from this study with seizures in the past year and no seizures in the past year compared to different populations from other studies [25,27]. (C) The mean MDI score with a 95% confidence interval for patients in this study with seizures in the past year and no seizures in the past year compares to a Danish general population [23].…”

“…Key characteristics of patients from the 'Funen cohort' responding to the survey and consenting to the use of electronic medical records (n = 113) did not differ from patients that did not respond or did not consent to being contacted (Supplementary Table 1). In this cohort, 85 patients previously completed a BIS-8 as part of a telephone interview as part of a related project [25], which allowed for validating the online survey. The Pearson correlation coefficient of the BIS-8 based on a telephone interview (n = 85) and the current online questionnaire, was 0.64 (p < 0.001); the correlation coefficient was 0.99 (p < 0.001) for current age (Supplementary Fig.…”

Electroencephalogram Image under Complex Domain Analysis Algorithm to Analyze Neurological Status Epilepticus and Poor Prognostic Factors of Children

“…So far, among the auxiliary diagnosis methods of epilepsy, EEG examination is one of the most important, valuable, and convenient methods [ 10 – 12 ]. Generally speaking, about 80% of epilepsy patients have EEG abnormalities in the intermittent period, while only 5%–20% of epilepsy patients can be normal in the intermittent period, which can be diagnosed as epilepsy [ 13 , 14 ]. The basic rhythm of brain electrical activity is composed of alpha waves of 8 to 13 weeks per second, and each nerve cell performs a rhythmic spontaneous discharge activity (consistent with the periodic depolarization of the nerve cell membrane), but its frequency is low and quite constant (10–20 cycles/sec) [ 15 ].…”