Amy Shakeshaft1,2, Naim Panjwani3, Robert McDowall1, Holly Crudgington1, Javier Peña Ceballos1, Danielle M Andrade4, Christoph P Beier5, Choong Yi Fong6, Joanna Gesche5, David A Greenberg7, Khalid Hamandi8, Jeanette Koht9,10, Kheng Seang Lim11, Alessandro Orsini12, Mark I Rees13, Guido Rubboli14,15, Kaja K Selmer16,17, Anna B Smith1, Pasquale Striano18,19, Marte Syvertsen9, Inga Talvik20, Rhys H Thomas21, Jana Zarubova22,23, Mark P Richardson1,2,24, Lisa J Strug3, Deb K Pal1,2,24,25. 1. Department of Basic & Clinical Neurosciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK. 2. MRC Centre for Neurodevelopmental Disorders, King's College London, UK. 3. The Hospital for Sick Children, Toronto, Canada. 4. Toronto Western Hospital, Canada. 5. Odense University Hospital, Odense, Denmark. 6. Division of Paediatric Neurology, Department of Paediatrics, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia. 7. Nationwide Children's Hospital, Ohio. 8. Cardiff & Vale University Health Board, UK. 9. Department of Neurology, Drammen Hospital, Vestre Viken Health Trust, Oslo, Norway. 10. University of Oslo, Oslo, Norway. 11. Division of Neurology, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia. 12. Department of Clinical & Experimental Medicine, Pisa University Hospital, Italy. 13. Neurology Research Group, Swansea University Medical School, UK. 14. Danish Epilepsy Centre, Dianalund, Denmark. 15. University of Copenhagen, Denmark. 16. Department of Research and Innovation, Division of Clinical Neuroscience, Oslo University Hospital, Norway. 17. National Centre for Epilepsy, Oslo University Hospital, Norway. 18. IRCCS Istituto 'G. Gaslini', Genova, Italy. 19. University of Genova, Genova, Italy. 20. Tallin Children's Hospital, Tallin, Estonia. 21. Newcastle upon Tyne NHS Foundation Trust, Newcastle, UK. 22. Department of Neurology, Motol University Hospital, Prague, Czech Republic. 23. Second Faculty of Medicine, Charles University, Prague, Czech Republic. 24. King's College Hospital, London, UK. 25. Evelina London Children's Hospital, London, UK.
Abstract
OBJECTIVE: 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.
OBJECTIVE: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.
Authors: Amy Shakeshaft; Naim Panjwani; Amber Collingwood; Holly Crudgington; Anna Hall; Danielle M Andrade; Christoph P Beier; Choong Yi Fong; Elena Gardella; Joanna Gesche; David A Greenberg; Khalid Hamandi; Jeanette Koht; Kheng Seang Lim; Rikke S Møller; Ching Ching Ng; Alessandro Orsini; Mark I Rees; Guido Rubboli; Kaja K Selmer; Pasquale Striano; Marte Syvertsen; Rhys H Thomas; Jana Zarubova; Mark P Richardson; Lisa J Strug; Deb K Pal Journal: Sci Rep Date: 2022-02-21 Impact factor: 4.379
Authors: Alessandro Orsini; Thomas Foiadelli; Attilio Sica; Andrea Santangelo; Niccolò Carli; Alice Bonuccelli; Rita Consolini; Sofia D'Elios; Nicolò Loddo; Alberto Verrotti; Giuseppe Di Cara; Chiara Marra; Maria Califano; Anna Fetta; Marianna Fabi; Stefania Bergamoni; Aglaia Vignoli; Roberta Battini; Marta Mosca; Chiara Baldini; Nadia Assanta; Pietro Marchese; Gabriele Simonini; Edoardo Marrani; Francesca Felicia Operto; Grazia Maria Giovanna Pastorino; Salvatore Savasta; Giuseppe Santangelo; Virginia Pedrinelli; Gabriele Massimetti; Liliana Dell'Osso; Diego Peroni; Duccio Maria Cordelli; Martina Corsi; Claudia Carmassi Journal: Int J Environ Res Public Health Date: 2022-08-25 Impact factor: 4.614