A cognitive rehabilitation program to improve hot and cool executive dysfunction in juvenile myoclonic epilepsy: Preliminary findings

Autor(es)

Paiva, Maria Luisa Maia Nobre ; Serafim, Antonio ; Vincentiis, Silvia ; Alessi, Ruda ; Marin, Rachel ; Melo, Marcio Braga ; Valente, Kette D.

• Tipo de documento: Artigo Científico
• Fonte: Epilepsy & Behavior; v. 144, p. 8-pg., 2023-06-03.

Resumo

Objective: Executive and attentional deficits are often described in Juvenile Myoclonic Epilepsy (JME). We aimed to evaluate the short-term impact of rehabilitation developed for the most frequent cognitive deficits of persons with JME. Methods: Thirty-three patients entered this study which consisted of 12 individual sessions once a 60-minute week, divided into planning/organization, attention, and impulsivity. Twenty-seven patients finished the protocol, and all patients had pre-and-post evaluations from neuropsychological tests and self-rating questionnaires. Generalized Estimating Equations (GEE) inferential statistics were used to verify the protocol's effect, and a 95% confidence interval was adopted. Results: We found significant improvement in selective attention (TMT A [p < 0.01] and Stroop test 2 [p = 0.03]), inhibitory control (Stroop test 3 [p = 0.02], FAS [p < 0.01], CPT commissions [p < 0.01]), mental flexibility [WCST categories p < 0.01] and implicit decision making (IGT blocks A [p < 0.01], B [p = 0.02], C [p < 0.01] and D [p < 0.01]). All components of the Behavioral Rating Index of Executive Functions metacognition index and the general quotient had significant improvement (initiative [p & LE; 0.01], working memory [p & LE; 0.01], planning and organization [p & LE; 0.01], task monitor [p = 0.02] and organization of materials [p = 0.02]). Regarding the Behavioral Regulation Index, the "Emotional Control" was improved [p = 0.03]. The attentional component and general scores of the Adult Self-Report Scale for Adults also changed significantly [p & LE; 0.01]. Significance: Executive function and attention had an improvement in objective and subjective tests. The context-dependent reactive mechanism of impulsivity improved in instruments based on the ecological evaluation. Our findings, though preliminary due to a lack of controls and practice effect corrections, sup-port that cognitive rehabilitation may be a valuable resource to alleviate cognitive deficits in patients with JME. & COPY; 2023 Elsevier Inc. All rights reserved. (AU)

• Processo FAPESP: 17/09870-9 - O impacto da reabilitação cognitiva nas funções executivas e adequação social nos pacientes com epilepsia mioclônica juvenilil
• Beneficiário: Maria Luisa Maia Nobre de Paiva
• Modalidade de apoio: Bolsas no Brasil - Mestrado