Clinical Trial: Co-operative Behavior and Decision-making in Frontal Lobe Epilepsy

Study Status: Completed
Recruit Status: Completed
Study Type: Interventional

Official Title: Co-operative Behavior and Decision-making in Frontal Lobe Epilepsy

Brief Summary:

Epilepsy is a frequent neurological disorder with about a third of patients having seizures despite treatment. At least some of these seizures can be linked to a low compliance and therapy adherence of patients. Compliance is defined as "the extent to which a person's behavior (in terms of taking medication, following diets, or executing life style changes) coincides with medical or health advice". Therapy adherence of patients suffering from epilepsy is low with reported rates between 30 and 50%, although adherence to anticonvulsive drug therapy is critical for effective disease management and low therapy adherence is associated to higher mortality in epilepsy. The reasons for low therapy adherence are still a matter of research. Some known factors influencing compliance in epilepsy are related to its chronic nature, but others seem to lie in a complex interaction between psychiatric comorbidity and an impairment of neural systems underlying behavior. Furthermore, therapy adherence rests a variable difficult to measure, especially in epileptic patients where classical tools such as questionnaires and electronic monitoring devices have been shown to be imprecise. It has been argued that the term 'compliance' should be replaced by 'co-operative behavior' and non-compliance can therefore be interpreted as troubled co-operative behavior. This behavioral approach offers the potential of using tools and methods of the latest developments in behavioral neuroscience. Neuroeconomics, a scientific field on the border of psychology, economics and neuroscience, has used economic game paradigms in order to operationalize cooperative behavior and to identify several brain areas by functional brain imaging that have been linked to social co-operative behavior. The majority of these brain areas are located in the frontal cortex [ventromedial frontal/orbitofrontal cortex, and rostral anterior cingulate cortex. Epilepsies origi

Detailed Summary:
Sponsor: Hospices Civils de Lyon

Current Primary Outcome: Social cooperative behavior as measured by the prisoners' dilemma game [ Time Frame: 1 day ]

The prisoners' dilemma game (PDG; Trivers, 1971) is a well-studied game derived from economic game theory that has been used extensively to quantify and study cooperative behavior. The two players in the game can choose between two moves, either "co-operate" or "defect". If both players co-operate, they both receive the reward R. If one player defects, while the other one co-operates, then the defector receives the payoff T while the co-operative player receives the payoff S. If both players defect, they both receive the payoff P. (T > R > P > S).


Original Primary Outcome: Same as current

Current Secondary Outcome:

  • Blood-oxygen-level dependent signal during the Prisoners' dilemma game [ Time Frame: 1 day ]
    Whole brain analysis of correlation between behavior in the PDG (prisoners' dilemma game) and brain activation as measured by the BOLD (blood-oxygen-level dependent) signal captured through functional MRI as well as group differences between patients and controls.
  • Neuropsychological profile [ Time Frame: 1 day ]
    analysis of neuropsychological testing of (working) memory, attention, theory-of-mind and executive functions.
  • Pill counts [ Time Frame: 1 day ]
    Pills taken and not-taken during the study period will be counted as a variable of therapy adherence.
  • Scores acquired by questionnaire [ Time Frame: 1 day ]
    Several questionnaires to cover beliefs about therapy adherence will be applied.
  • Scores acquired by questionnaire [ Time Frame: 1 day ]
    questionnaire to cover beliefs about medicines will be applied
  • Scores acquired by questionnaire [ Time Frame: 1 day ]
    questionnaire to cover beliefs about trust towards physicians and medications will be applied


Original Secondary Outcome: Same as current

Information By: Hospices Civils de Lyon

Dates:
Date Received: April 3, 2015
Date Started: February 2015
Date Completion:
Last Updated: September 21, 2015
Last Verified: September 2015