Trait impulsivity in Juvenile Myoclonic Epilepsy

Shakeshaft, Amy and Panjwani, Naim and McDowall, Robert and Crudgington, Holly and Ceballos, Javier Pena and Andrade, Danielle M. and Beier, Christoph P. and Fong, Choong Yi and Gesche, Joanna and Greenberg, David A. and Hamandi, Khalid and Koht, Jeanette and Lim, Kheng Seang and Orsini, Alessandro and Rees, Mark and Rubboli, Guido and Selmer, Kaja K. and Smith, Anna B. and Striano, Pasquale and Syvertsen, Marte and Talvik, Inga and Thomas, Rhys H. and Zarubova, Jana and Richardson, Mark P. and Strug, Lisa J. and Pal, Deb K. and Consortium, BIOJUME (2021) Trait impulsivity in Juvenile Myoclonic Epilepsy. Annals of Clinical and Translational Neurology, 8 (1). pp. 138-152. ISSN 2328-9503, DOI

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Impulsivity is a multidimensional construct that can predispose to psychopathology. Meta-analysis demonstrates an association between response impulsivity and Juvenile Myoclonic Epilepsy (JME), a common genetic generalized epilepsy. Here, we test the hypotheses that trait impulsivity is (i) elevated in JME compared to controls; (ii) moderated by specific seizure characteristics; and (iii) associated with psychiatric adverse effects of antiepileptic drugs (AEDs). Methods: 322 participants with JME and 126 age and gender-matched controls completed the Barratt's Impulsiveness Scale (BIS-brief) alongside information on seizure history and AED use. We compared group BIS-brief scores and assessed associations of JME BIS-brief scores with seizure characteristics and AED adverse effects. Results: The mean BIS-brief score in JME was 18.1 +/- 4.4 compared with 16.2 +/- 4.1 in controls (P = 0.0007). Elevated impulsivity was associated with male gender (P = 0.027), frequent absence seizures (P = 0.0004) and lack of morning predominance of myoclonus (P = 0.008). High impulsivity significantly increased the odds of a psychiatric adverse event on levetiracetam (P = 0.036), but not any other psychiatric or somatic adverse effects.Interpretation: Trait impulsivity is elevated in JME and comparable to scores in personality and neurotic disorders. Increased seizure frequency and absence of circadian seizure pattern moderate BIS score, suggesting disruption of both cortico-striatal and thalamocortical networks as a shared mechanism between seizures and impulsivity in JME. These findings warrant consideration of impulsivity as a distinct target of intervention, and as a stratifying factor for AED treatment in JME, and perhaps other types of epilepsy. The role of impulsivity in treatment adherence and psychosocial outcome requires further investigation.

Item Type: Article
Funders: Canadian Institutes of Health Research (CIHR)[201503MOP-342469], Canadian Institutes of Health Research (CIHR)[ 201809FDN-407295], European Commission[602531], UK Research & Innovation (UKRI) Medical Research Council UK (MRC)[MR/N026063/1], UK Research & Innovation (UKRI) Medical Research Council UK (MRC)[MR/K013998/1], Waterloo Foundation Project Grant[164-3020], Charles Sykes Epilepsy Research Trust, NIHR Specialist Biomedical Research Centre for Mental Health of South London and Maudsley National Health Service Foundation Trust, NIHR, Biomedical Research Centre at South London and Maudsley NHS Foundation Trust, UK Engineering and Physical Sciences Research Council, Centre for Predictive Modelling in Healthcare[EP/N014391/1], DINOGMI Department of Excellence of MIUR 2018-2022, Health and Care Research Wales -BRAIN Unit and Research Delivery Staff, BioMarin srl, GW Pharmaceuticals, South-Eastern Regional Health Authority, Norway[2016129], Research Council of Norway[299266], Epilepsy Research UK, Health & Care Research Wales, Abertawe Bro Morgannwg University NHS RD, UCB Pharma SA, Ohio State University, Odense University Hospital, University of Southern Denmark[17/18517], Kolfarma srl., UK Research & Innovation (UKRI) Engineering & Physical Sciences Research Council (EPSRC)[EP/N014391/1]
Uncontrolled Keywords: Attention-deficit/hyperactivity disorder;Generalized epilepsy;Connectivity;Population;Domains;Adults;Sleep;Scale
Subjects: R Medicine
R Medicine > RC Internal medicine
R Medicine > RC Internal medicine > RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry
Divisions: Faculty of Medicine
Depositing User: Ms Zaharah Ramly
Date Deposited: 15 Sep 2022 07:55
Last Modified: 15 Sep 2022 07:55

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