Journal of Neurology

, Volume 260, Issue 3, pp 839–846 | Cite as

Decision making in juvenile myoclonic epilepsy

  • Laura Zamarian
  • Julia Höfler
  • Giorgi Kuchukhidze
  • Margarete Delazer
  • Elisabeth Bonatti
  • Georg Kemmler
  • Eugen Trinka
Original Communication


Recent neuroimaging studies have reported structural and functional brain abnormalities in patients with juvenile myoclonic epilepsy (JME), which may also involve cortical and subcortical networks that are important for decision making. This study is the first attempt to examine decision making in JME. Twenty-two patients with JME (median age 26.00, range 18–50) and 33 healthy controls (median age 26.00, range 18–57) participated in the study. For the JME group, the median age at seizure onset was 14.00 years (range 1–20); the median epilepsy duration was 11.50 years (range 3–45). Eleven patients (50 %) had pharmacoresistant seizures. All participants completed the Iowa Gambling Task (IGT), a widely used standard task of decision making. In this task, contingencies are not explained and feedback on previous decisions has to be used in order to learn to choose the advantageous alternatives. In the IGT, patients with JME showed difficulty in learning to choose advantageously compared to healthy controls. Difficulty was enhanced for the patients with pharmacoresistant seizures. A correlation analysis revealed an association between decision-making performance of patients with JME and executive functions. Results indicate that patients with JME have difficulty in making advantageous decisions and that persistence of seizures might be a critical factor for cognitive functioning. Findings of this study add a new aspect to the neuropsychological profile of JME. Difficulty in decision making may impair functioning of patients with JME in everyday life and affect their adherence to treatment plans.


Idiopathic generalized epilepsy Juvenile myoclonic epilepsy Decision making Executive functions Neuropsychology 

Supplementary material

415_2012_6715_MOESM1_ESM.docx (32 kb)
Supplementary material 1 (DOCX 32 kb)


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Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  • Laura Zamarian
    • 1
  • Julia Höfler
    • 1
    • 2
  • Giorgi Kuchukhidze
    • 1
  • Margarete Delazer
    • 1
  • Elisabeth Bonatti
    • 3
  • Georg Kemmler
    • 4
  • Eugen Trinka
    • 1
    • 2
  1. 1.Department of NeurologyMedical University of InnsbruckInnsbruckAustria
  2. 2.Department of Neurology, Christian Doppler KlinikParacelsus Medical University of SalzburgSalzburgAustria
  3. 3.Department of PediatricsMedical University of InnsbruckInnsbruckAustria
  4. 4.Department of PsychiatryMedical University of InnsbruckInnsbruckAustria

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