title: Executive functions and psychiatric symptoms in drug-refractory juvenile myoclonic epilepsy.
abstract: OBJECTIVE
  The pattern of executive dysfunction reported in juvenile myoclonic epilepsy (JME) resembles that of patients with cluster B personality disorders. This study examined whether executive dysfunction and maladaptive behavior reported in patients with JME are related.
  
  
  METHODS
  Sixty patients with drug-refractory JME were administered tests of intellect, memory, and executive dysfunction. Anxiety, depression, personality traits, impact of epilepsy, and perceived cognitive effects of antiepileptic drugs were measured.
  
  
  RESULTS
  Half of the cohort exhibited moderate to severe anxiety symptoms. The patients performed most poorly on naming ability and inhibition switching. Duration of epilepsy exacerbated poor performance on inhibition switching. Females presented with pathological scores for neurotic and introvert traits and males for introvert traits. Abnormal personality traits and psychiatric disorders were associated with worse intellectual and executive functioning. People with extreme Eysenck Personality Scale - Brief Version (EPQ-BV) scores demonstrated the greatest level of executive impairment. Furthermore, the same degree of dysfunction was not seen in any individual with unremarkable EPQ-BV scores.
  
  
  CONCLUSIONS
  This study indicates that specific patterns of executive dysfunction are related to maladaptive behavior in JME. Distinct behavioral patterns may be used to identify functional and anatomical differences between people with JME and for stratification to enable gene discovery.
authors.affiliation: Department of Clinical and Molecular Pharmacology, University of Liverpool, Liverpool, UK. Electronic address: Jordana.walsh@gosh.nhs.uk.
authors.forename: Jordana
authors.initials: J
authors.lastname: Walsh
authors.affiliation: College of Medicine, Institute of Life Science, Swansea University, Swansea, UK; Wales Epilepsy Research Network (WERN), College of Medicine, Swansea University, Swansea, UK.
authors.forename: Rhys H
authors.initials: RH
authors.lastname: Thomas
authors.affiliation: Department of Clinical and Molecular Pharmacology, University of Liverpool, Liverpool, UK.
authors.forename: Carla
authors.initials: C
authors.lastname: Church
authors.affiliation: College of Medicine, Institute of Life Science, Swansea University, Swansea, UK; Wales Epilepsy Research Network (WERN), College of Medicine, Swansea University, Swansea, UK.
authors.forename: Mark I
authors.initials: MI
authors.lastname: Rees
authors.affiliation: Department of Clinical and Molecular Pharmacology, University of Liverpool, Liverpool, UK.
authors.forename: Anthony G
authors.initials: AG
authors.lastname: Marson
authors.affiliation: Department of Clinical and Molecular Pharmacology, University of Liverpool, Liverpool, UK.
authors.forename: Gus A
authors.initials: GA
authors.lastname: Baker
mesh_terms: D000328:Adult; D003072:Cognition Disorders / Q000175:diagnosis / Q000209:etiology*; D056344:Executive Function / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000209:etiology*; D020190:Myoclonic Epilepsy, Juvenile / Q000150:complications* / Q000523:psychology*; D009483:Neuropsychological Tests; D010551:Personality; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Anxiety; Executive functions; Juvenile myoclonic epilepsy; Neuroticism; Personality