title: Are personality traits of juvenile myoclonic epilepsy related to frontal lobe dysfunctions? A proton MRS study.
abstract: OBJECTIVE
  Personality traits characterized by emotional instability and immaturity, unsteadiness, lack of discipline, hedonism, frequent and rapid mood changes, and indifference toward one's disease have been associated with patients who have juvenile myoclonic epilepsy (JME). Literature data demonstrate worse seizure control and more psychosocial dysfunctions among patients with JME who have those traits. In this controlled study we performed a correlation analysis of psychiatric scores with magnetic resonance spectroscopy (MRS) values across JME patients, aiming to verify the existence of a possible relation between frontal lobe dysfunction and the prevalence of personality disorders (PDs) in JME.
  
  
  METHODS
  Sixteen JME patients with cluster B PDs, 41 JME patients without any psychiatric disorder, and 30 healthy controls were submitted to a psychiatric evaluation and to a quantitative multivoxel MRS of thalamus; insula; cingulate gyrus; striatum; and frontal, parietal, and occipital lobes. Groups were homogeneous according to age, gender, and manual dominance. Psychiatric evaluation was performed through the Scheduled Clinical Interview for DSM-IV, Axis I and II (SCID I and II, respectively).
  
  
  RESULTS
  A significant reduction of N-acetyl-aspartate over creatinine (NAA/Cr) ratio was observed mainly in the left frontal lobe in the JME and PD group. In addition, a significant increase in the glutamate-glutamine over creatinine GLX/Cr ratio was also observed in this referred region in the same group.
  
  
  CONCLUSIONS
  These data support the hypothesis that PDs in JME could represent neuronal dysfunction and possibly a more severe form of this epileptic syndrome.
authors.affiliation: Department of Neurology, Universidade Federal de São Paulo/UNIFESP, São Paulo, Brazil. filho.gerardo@gmail.com
authors.forename: Gerardo Maria
authors.initials: GM
authors.lastname: de Araújo Filho
authors.forename: Katia
authors.initials: K
authors.lastname: Lin
authors.forename: Jaime
authors.initials: J
authors.lastname: Lin
authors.forename: Mirella M
authors.initials: MM
authors.lastname: Peruchi
authors.forename: Luís Otávio S F
authors.initials: LO
authors.lastname: Caboclo
authors.forename: Mirian S B
authors.initials: MS
authors.lastname: Guaranha
authors.forename: Laura M F F
authors.initials: LM
authors.lastname: Guilhoto
authors.forename: Henrique
authors.initials: H
authors.lastname: Carrete
authors.forename: Elza Márcia T
authors.initials: EM
authors.lastname: Yacubian
mesh_terms: D000293:Adolescent; D000328:Adult; D001224:Aspartic Acid / Q000031:analogs & derivatives / Q000378:metabolism; D001927:Brain Diseases / Q000150:complications* / Q000378:metabolism; D003401:Creatine / Q000378:metabolism; D005260:Female; D005625:Frontal Lobe / Q000378:metabolism / Q000473:pathology*; D018698:Glutamic Acid / Q000378:metabolism; D005973:Glutamine / Q000378:metabolism; D006801:Humans; D008279:Magnetic Resonance Imaging; D009682:Magnetic Resonance Spectroscopy / Q000379:methods; D008297:Male; D020190:Myoclonic Epilepsy, Juvenile / Q000150:complications / Q000378:metabolism / Q000473:pathology; D010551:Personality; D010554:Personality Disorders / Q000150:complications* / Q000378:metabolism; D010555:Personality Inventory; D011522:Protons; D011569:Psychiatric Status Rating Scales; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D011522:Protons; D005973:Glutamine; D001224:Aspartic Acid; D018698:Glutamic Acid; C000179:N-acetylaspartate; D003401:Creatine