Charakterisierung und Training frontaler Dysfunktionen bei juveniler myoklonischer Epilepsie (JME)

Das Ziel der vorliegenden klinischen Studie war es, erstmals ein Schulungsprogramm für Patienten mit JME zu schaffen, welches die eigene Wahrnehmung- und Achtsamkeit trainiert, um geeignete Kompensationsmechanismen zu finden, Lösungsansätze zu erlernen, die psychosozialen, alltagsrelevante Schwierig...

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Bibliographic Details
Main Author: Huber, Anna-Sophia
Contributors: Knake, Susanne (Prof., Dr.) (Thesis advisor)
Format: Doctoral Thesis
Language:German
Published: Philipps-Universität Marburg 2023
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The main goal of the study was the creation of an intervention program specifically aimed at people with juvenile myoclonic epilepsy trying to improve their aware- and mindfulness in order to better cope with daily psychosocial struggles caused by this disease. To measure the effectiveness psychometric and neuropsychological tests were used at the start of, end of, and six months after the intervention. On the one hand alexithyma, mood and social skills were key aspects to the psychometric tests. On the other hand cognition, attention, memory, and executive functions were tested in the neuropsychological assessments. This intervention program is based on a metacognitive training program for schizophrenia which also includes theory of mind (ToM) elements. Therefore the training was specifically modified for JME. That meant each person in the sample participated in a five week training program which initially taught the psychoeducational basis of JME, followed by relaxation and ToM exercises based on MCT. Additionally, the participants were given homework for each week manifesting the learned methods. All that combined enhanced the social cognition and overall coping with JME. Not all tests were significant, but some results definitely indicated the effectiveness of this intervention. For example, the significance in self-efficacy increased immediately after the training and also in the six months later follow up session. The results of the epilepsy management questionnaire showed a better understanding and coping with JME. Scores for overall alexithymia and difficulties in emotion identification increased from post training to the six month follow up session. Furthermore, significant effects of alexithyma, like the perception of feelings, indicated an improvement in awareness and social cognition. Some tests weren’t significant but trends in reflexibility, externally oriented thinking or neuropsychological tests like attention and working memory confirmed the efficiency of the training in different kinds of ways. Other than the results just mentioned, the patient’s stress levels decreased significantly after each module. Due to long term seizure-free periods, experienced by all participants, a further reduction in this matter could not be properly measured. With the only exception being one patient who had a single seizure within the 12 months prior the intervention. 150 Presently there’re only few therapy options for patients with JME. The method discussed in this paper still needs further validation and elaboration to confirm it’s results. However, the most effective therapy for JME patients would most likely be a combination of this specific MCT and pharmacological treatments.