Abstracts

Rationale: The Juvenile Myoclonic Epilepsy (JME) is a generalized genetically determined epileptic syndrome with an onset in adolescence and early adult life. Patients with JME may have specific cognitive deficits, mostly involving Executive Functions (EF), such as planning, attention, and impulse control. The evaluation of EF in epilepsy is performed with standard neuropsychological tests. However, this evaluation may underestimate patients' difficulties in daily life activities. The Behavior Rating Inventory of Executive Function-Adult version (BRIEF-A) is a questionnaire that aims to assess the frequency that patients exhibit dysexecutive behavior using daily-life examples. We aimed to evaluate and compare the EF of patients with JME and age and gender-matched controls with an ecological instrument. We also investigated the impact of clinical variables of these patients in EF scores. Methods: We prospectively evaluated 36 patients with JME (mean age 28.9 years, SD 9.49, 64.8% female, mean IQ 107.5) and 30 healthy controls (mean age 28.9, SD 10.4, 46.6% female, mean IQ 115.9) with the BRIEF-A questionnaire. The results from BRIEF-A were analyzed according to its nine theoretically and empirically clinical derived scores: Inhibit, Self-Monitor, Plan/Organize, Shift, Initiate, Task Monitor, Emotional Control, Working Memory, and Organization of Materials. Furthermore, three summary index scores resulting from the questionnaire were analyzed: The Behavioral Regulation Index (BRI), Metacognition Index (MCI) and Global Executive Composite (GEC). We also evaluated the association between the scores obtained with BRIEF and clinical variables (age at onset, epilepsy duration, presence of psychiatric diagnosis, seizure control, and drug regimen). The statistical analysis was done using the t-test and the Mann Whitney test for parametric and nonparametric variables, respectively. A confidence interval of 95% was adopted. Results: Patients with JME had higher scores compared to controls for all BRIEF-A scores (table 1). There was no correlation between BRIEF-A scores and clinical variables analyzed, except for polytherapy (p = 0.054). Conclusions: The BRIEF-A is a proper measure of daily life impact of executive functions deficits in persons with JME and may be used by clinicians to identify the patient's cognitive profile and, consequently guide their treatment. This study is the first that evaluates EF through an ecological measure in adults with JME. Funding: FAPESP