A comprehensive neuropsychological description of cognition in drug-refractory juvenile myoclonic epilepsy

Epilepsy Behav. 2014 Jul:36:124-9. doi: 10.1016/j.yebeh.2014.04.027. Epub 2014 Jun 2.

Abstract

The study of juvenile myoclonic epilepsy is important in that: it is common and heterogeneous; the etiology is unknown; and patients report broad cognitive problems. We utilized a broad battery of neuropsychometric tests to assess the following: intellectual function, memory, language and naming, executive function, the impact of epilepsy, and antiepilepsy drug side effects. Sixty people with drug-refractory JME were interviewed, and performance was profoundly impaired across the range of tests. Impairments included the following: full-scale IQ (89, p<0.001); processing speed (86, p<0.001); visual memory (immediate and delayed) more affected than verbal memory; verbal fluency and inhibition (p<0.001); and self-reported drug side effects (p<0.001). Eighty-three percent of patients exhibited frank executive dysfunction, which was moderate to severe in 66%. Regression modeling confirmed that an early age at onset and the need for polytherapy were associated with poorer cognitive outcomes. This study confirms previous reports of executive dysfunction in a larger cohort and with greater statistical rigor. We also identified a high prevalence of neurotoxicity symptoms such as fatigue and poorer functioning across intellectual and memory tests than had previously been reported.

Keywords: Cognition; Executive function; Juvenile myoclonic epilepsy; Memory; Psychology.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anticonvulsants / therapeutic use
  • Attention
  • Cognition Disorders / diagnosis*
  • Cognition Disorders / etiology*
  • Cohort Studies
  • Executive Function
  • Female
  • Humans
  • Intelligence
  • Magnetic Resonance Imaging
  • Male
  • Memory Disorders / diagnosis
  • Memory Disorders / etiology
  • Myoclonic Epilepsy, Juvenile / complications*
  • Myoclonic Epilepsy, Juvenile / drug therapy
  • Neuropsychological Tests*
  • Regression Analysis
  • Surveys and Questionnaires
  • Verbal Learning

Substances

  • Anticonvulsants