Abstract
Objective In this study, we aimed to evaluate the executive profile of juvenile myoclonic epilepsy (JME) patients using the Frontal Assessment Battery (FAB) as a bedside screening tool and investigate its association with seizure proximity, family history of epilepsy, and polytherapy/monotherapy with antiepileptic drugs (AEDs). Background JME patients have deficits in various aspects of executive functions. FAB has proved to be a useful tool for evaluating executive functions in clinical settings. Methods Thirty-one JME patients and 110 healthy controls (HCs) were enrolled in this study. The participants were assessed using six subsets of FAB, including conceptualization, mental flexibility, motor programming, sensitivity to interference, inhibitory control, and environmental autonomy. Results Compared to HCs, JME patients showed lower scores in conceptualization, mental flexibility, programming, sensitivity to interference, and total FAB. The number of AEDs (polytherapy versus monotherapy) and duration of time since the last seizure had no significant effect on FAB scores in JME patients. We found significant associations between disease duration and conceptualization, mental flexibility, inhibitory control, and total FAB score only in JME patients with recent seizure. Finally, receiver operating characteristic (ROC) analysis showed area under the curve (AUC) of 0.971 (95% confidence interval (CI): 0.947–0.994) for FAB total score, 0.933 for conceptualization (95% CI: 0.973-894), and 0.836 for mental flexibility (95% CI: 0.921-751). Conclusions In summary, JME patients had deficits in different aspects of executive functions. FAB is a useful clinical tool for evaluation of executive functions in JME patients.
Highlights
Juvenile myoclonic epilepsy (JME) is an adolescent-onset idiopathic generalized epilepsy syndrome, which constitutes around 5% to 10% of all epilepsies and 18% of generalized epilepsies [1]
We aimed to evaluate the executive functions in JME patients using Frontal Assessment Battery (FAB)
healthy controls (HCs) had better scores in total FAB comparing with JME patients (P value < 0.0001)
Summary
Juvenile myoclonic epilepsy (JME) is an adolescent-onset idiopathic generalized epilepsy syndrome, which constitutes around 5% to 10% of all epilepsies and 18% of generalized epilepsies [1]. JME is mainly characterized by seizures with repetitive, arrhythmic, and irregular myoclonic jerks, which are predominantly present in the arms after awakening [2]. Patients with JME have average intelligence, JME is usually associated with cognitive impairments in various areas of cognition, including concept formation, abstract reasoning, cognitive speed, planning, and organization [3]. Executive functions are reflected as high-level processes required for a variety of cognitive abilities including attention, the formation of complex thoughts, and performing appropriate behaviors [4] which are mainly dependent on the intact function of frontal lobes. The degree of executive dysfunction in JME patients is variable [5], many
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