The effects of adjunctive topiramate on cognitive function in patients with epilepsy
The effects of adjunctive topiramate on cognitive function in patients with epilepsy
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DOI：
10.1046/j.1528-1157.2003.27402.x
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发表时间：
2003-03-01
期刊：
影响因子：
5.6
通讯作者：
Jones-Gotman, M
中科院分区：
文献类型：
--
作者：
Lee, S;Sziklas, V;Jones-Gotman, M
目的：探讨托吡酯（TPM）对顽固性癫痫患者可能的认知影响。方法：研究1对22例连续入住蒙特利尔神经医院的抗癫痫药物（aed）包括TPM的患者进行评估。分析了在TPM上和随后在TPM下进行的神经心理测试的表现。四名患者在服用TPM之前也进行了测试，然后进行比较，然后再次停用该药物。测试包括智力功能、言语和非言语记忆、语言、单词和设计流畅性、体感灵敏度和运动技能。在研究2中，明尼苏达州癫痫组的16名患者首先接受了测试，然后在TPM上进行了9项认知任务，这些任务测量了注意力、语言流畅性、语言和精神运动速度。结果：在研究1中，在包括语言和非语言流畅性以及某些语言和感知任务在内的13项测量中，观察到TPM显著（p小于或等于0.01）的改善。值得注意的是，语言学习和记忆没有受到影响；对非语言记忆的影响有限。接受3次测试的患者在两项测试中均比服用该药的患者得分更高。在研究2中，在所有测试中都观察到TPM下降，在流畅性、持续注意力和视觉运动处理速度测试中显著（p小于或等于0.05）。结论：TPM与流畅性、注意力/集中、处理速度、语言技能和感知能力的下降有关；工作记忆受到影响，但记忆力没有受到影响。由于这两项研究使用了相反的测试顺序，我们的结果清楚地表明，当患者服用TPM时，性能下降，而不考虑哪一种情况先测试。
Purpose: We investigated possible cognitive effects of topiramate (TPM) in polypharmacy on patients with intractable epilepsy.Methods: Study 1 evaluated 22 consecutively admitted patients whose antiepileptic drugs (AEDs) on admission to the Montreal Neurological Hospital included TPM. Performance on neuropsychological tests administered on and subsequently off TPM was analyzed. Four patients also were tested before taking TPM, allowing comparisons off, then on, and then off the drug again. Measures included intellectual function, verbal and nonverbal memory, language, word and design fluency, somatosensory sensitivity, and motor skills. In Study 2, 16 patients at the Minnesota Epilepsy Group were tested first off, then on TPM with nine cognitive tasks that measured concentration, verbal fluency, language, and psychomotor speed.Results: In Study 1, significant (p less than or equal to 0.01) improvements were observed off TPM on 13 measures including verbal and nonverbal fluency and certain verbal and perceptual tasks. Notably, verbal learning and memory were unaffected; a limited effect was observed on nonverbal memory. Patients tested 3 times scored better in both tests off TPM compared with on this drug. In Study 2, declines on TPM were observed on all measures, significantly (p less than or equal to 0.05) for tests of fluency, sustained concentration, and Visual motor processing speed.Conclusions: TPM was associated with declines in fluency, attention/concentration, processing speed, language skills, and perception; working memory but not retention was affected. As the two studies used an opposite order of testing on versus off TPM, our results clearly show a performance decrement while patients are taking TPM, without respect to which condition is tested first.