title: Personality traits in juvenile myoclonic epilepsy: evidence of cortical abnormalities from a surface morphometry study.
abstract: Cluster B personality disorders (PD), characterized as emotional instability, immaturity, lack of discipline, and rapid mood changes, have been observed among patients with juvenile myoclonic epilepsy (JME) and have been associated with a worse seizure outcome. Proper understanding of the neurobiology of PD associated with JME could contribute to understanding the basis for earlier and more effective interventions. In the present study, volumetric and geometric features of cortical structure were assessed through an automated cortical surface reconstruction method aiming to verify possible structural cortical alterations among patients with JME. Twenty-two patients with JME with cluster B PD, 44 patients with JME without psychiatric disorders, and 23 healthy controls were submitted to a psychiatric evaluation through SCID I and SCID II and to an MRI scan. Significant cortical alterations in mesiofrontal and frontobasal regions, as well as in other limbic and paralimbic regions, were observed mainly in patients with JME with PD. The present study adds evidence to the hypothesis of frontal and limbic involvement in the pathophysiology of cluster B PD in JME, regions linked to mood and affective regulation, as well as to impulsivity and social behavior. Moreover, a multidimensional pattern of frontal, limbic, and paralimbic changes was observed through a method of structural analysis which offers different and simultaneous geometric features, allowing the elaboration of important pathophysiologic insights about cluster B PD in JME.
authors.affiliation: Laboratório Interdisciplinar de Neurociências Clínicas (LiNC), Department of Psychiatry, Universidade Federal de São Paulo/UNIFESP, São Paulo, Brazil. filho.gerardo@gmail.com
authors.forename: Gerardo Maria
authors.initials: GM
authors.lastname: de Araujo Filho
authors.forename: Thabata Bueno
authors.initials: TB
authors.lastname: de Araujo
authors.forename: João Ricardo
authors.initials: JR
authors.lastname: Sato
authors.forename: Ivaldo da
authors.initials: Id
authors.lastname: Silva
authors.forename: Katia
authors.initials: K
authors.lastname: Lin
authors.forename: Henrique Carrete
authors.initials: HC
authors.lastname: Júnior
authors.forename: Elza Márcia T
authors.initials: EM
authors.lastname: Yacubian
authors.forename: Andrea Parolin
authors.initials: AP
authors.lastname: Jackowski
mesh_terms: D000328:Adult; D001931:Brain Mapping; D002540:Cerebral Cortex / Q000473:pathology*; D004569:Electroencephalography; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D020190:Myoclonic Epilepsy, Juvenile / Q000150:complications* / Q000473:pathology*; D010554:Personality Disorders / Q000150:complications*; D011569:Psychiatric Status Rating Scales; D055815:Young Adult