[Topiramate and epilepsy in the light of Das-Naglieri Cognitive Assessment System].
BACKGROUND
Cognitive side effect is a possible effect of topiramate. Cognitive function is not unanimously defined and a test measures according to the concept is based on. On the other hand, behavioral dysfunction is frequent in epileptics and the euthimic effect of topiramate on impulsive dysfunction is known.


OBJECTIVE
To asses the cognitive effect of topiramate with a modern battery, Das-Naglieri Cognitive Assessment System (DN:CAS), which diagnoses mental programs, but not only achievement. Also, to test the influence of topiramate on behavior.


METHODS
As a prospective study, 35 patients with idiopathic or cryptogenic epilepsies were administered DN:CAS battery, and, simultaneously, patients and parents were given behavioral questionnaires at baseline, and after 6 and 12 months on topiramate. Cognitive scores were compared to those of a group of healthy controls at baseline, and baseline scores were compared to 6 and 12 months follow-up scores within the patient group. t-Student was applied.


RESULTS
Patient scores were lower in successive processing before treatment as compared to controls (p < 0.001). After 6 months no change was noted. After 12 months of treatment, patients scored significantly better in planning processing than before treatment (p = 0.04) and, moreover, improved behavioral scores were noted.


CONCLUSIONS
The patients showed a successive processing dysfunction not related with topiramate. An improved planning processing and behavioral pattern were observed 12 months after treatment. According to the euthimic effect of topiramate and the neurocognitive-neuroimpulsive interaction, a positive effect of topiramate on DN:CAS cognition and behavior can be postulated.
Pérez-Alvarez
F
F
Unidad de Neuropediatría, Neurología de la Conducta, Hospital Universitari Dr. Josep Trueta, Girona, Spain. fpereza@comg.es
Timoneda-Gallart
C
C
Baus-Rosell
J
J
D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000494:pharmacology / Q000627:therapeutic use*; D001519:Behavior / Q000187:drug effects; D002675:Child, Preschool; D003071:Cognition / Q000187:drug effects*; D004827:Epilepsy / Q000188:drug therapy* / Q000503:physiopathology; D005632:Fructose / Q000031:analogs & derivatives* / Q000494:pharmacology / Q000627:therapeutic use; D006801:Humans; D009483:Neuropsychological Tests; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D000077236:Topiramate
D000927:Anticonvulsants; D000077236:Topiramate; D005632:Fructose