Comparison of antiepileptic drugs on cognitive function in newly diagnosed epileptic children: a psychometric and neurophysiological study
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1Department of Pediatrics, College of Medicine, National Cheng Kung University, Tainan, Taiwan, R.O.C.
Insights
Phenobarbital (PB) may impact cognitive function in children with epilepsy, unlike carbamazepine (CBZ) or valproate (VPA). Auditory event-related potentials (P 300) showed increased latency with PB, suggesting its utility in assessing antiepileptic drug effects.
Area of Science:
- Neuroscience
- Pediatric Neurology
- Clinical Pharmacology
Background:
- Epilepsy is a common neurological disorder in children.
- Antiepileptic drugs (AEDs) are crucial for managing epilepsy but can have cognitive side effects.
- Understanding the differential cognitive impact of various AEDs is essential for optimizing treatment.
Purpose of the Study:
- To compare the cognitive effects of three commonly used AEDs: carbamazepine (CBZ), phenobarbital (PB), and valproate (VPA) in children with newly diagnosed epilepsy.
- To investigate changes in cognitive function using standardized tests and neurophysiological measures.
- To determine if specific AEDs are associated with distinct cognitive alterations.
Main Methods:
- A randomized parallel group study design was employed.
- Seventy-three children with newly diagnosed epilepsy were enrolled.
- Cognitive function was assessed using the Wechsler Intelligence Scale for Children-Revised (WISC-R), Bender-Gestalt test, and auditory event-related potentials (P 300) at baseline, 6, and 12 months post-treatment.
Main Results:
- No significant differences in WISC-R IQs or Bender-Gestalt scores were observed among the groups.
- Children receiving phenobarbital (PB) showed increased P 300 latencies compared to baseline and other groups.
- Auditory P 300 amplitudes were reduced across all AED groups, but without significant inter-group differences.
Conclusions:
- Phenobarbital (PB) may have a discernible impact on cognitive function in epileptic children, indicated by altered P 300 latency.
- The auditory P 300 response appears to be a sensitive neurophysiological marker for detecting subtle cognitive effects of AEDs.
- Carbamazepine (CBZ) and valproate (VPA) did not show significant cognitive effects on the measures used in this study.
Abstract:
Using a randomized parallel group study design, we compared the cognit ive effects of carbamazepine (CBZ), phenobarbital (PB), and valproate (VPA) in children with epilepsy. Seventy-three children with newly diagnosed epilepsy were tested with the Wechsler Intelligence Scale for Children-Revised (WISC-R), Bender-Gestalt test, and auditory event-related potentials (P 300) before and 6 and 12 months after antiepileptic drug (AED) treatment. There were no significant differences in WISC-R IQs and Bender-Gestalt scores for children in any group at any of the three sessions. P 300 latencies were increased in the children receiving PB but not in children receiving CBZ and VPA. P 300 amplitudes were significantly reduced in treated children in all three groups, but amplitudes were not significantly different among the three groups. These findings suggest that PB may affect cognitive function of epileptic children and that the P 300 may be a sensitive additional procedure that can be used to assess the cognitive effect of AEDs.