Antiepileptic monotherapy significantly impairs normative scores on common tests of executive functions.
BACKGROUND
Understanding how antiepileptic (AED) monotherapy influences normative test scores is of importance in the clinic for correct interpretation of neuropsychological profiles. Previous studies have primarily reported minor influence on neuropsychological raw scores, and the clinical relevance of these findings is unclear.


OBJECTIVE
To obtain a clinical valid answer to this question, we analysed changes in T-scores after AED withdrawal in a large group of well-controlled epilepsy patients, for tests previously shown to be sensitive to AED withdrawal.


METHODS
We report outcomes on measures of choice reaction time from the California Computerized Assessment Package, on the Controlled Oral Word Association Test and on the Stroop Color-Word Interference Test.


RESULTS
Significantly improved T-scores were revealed after AED withdrawal on five of the six tests of executive functions with mean improvement of 5 T-scores. Comparable results were achieved in the subgroup taking carbamazepine, with a mean improvement of 6.2 T-scores.


CONCLUSIONS
The present results suggest that T-scores for computerized tests of choice reaction time and tests of verbal fluency and response inhibition may be significantly impaired as a consequence of AED monotherapy, and that careful interpretation of these scores is required in diagnostic assessment of patients receiving AED monotherapy.
Hessen
E
E
Department of Neurology, Akershus University Hospital, Oslo, Norway. erik.hessen@nevropsykologi.no
Lossius
M I
MI
Gjerstad
L
L
D000293:Adolescent; D000328:Adult; D000368:Aged; D000927:Anticonvulsants / Q000009:adverse effects* / Q000494:pharmacology; D002755:Choice Behavior / Q000187:drug effects; D004311:Double-Blind Method; D004827:Epilepsy / Q000188:drug therapy / Q000523:psychology; D005260:Female; D006801:Humans; D007266:Inhibition, Psychological; D007807:Language Tests; D008297:Male; D008606:Mental Processes / Q000187:drug effects*; D008875:Middle Aged; D009483:Neuropsychological Tests; D009664:Norway; D011930:Reaction Time / Q000187:drug effects; D014705:Verbal Behavior / Q000187:drug effects; D014936:Word Association Tests; D055815:Young Adult
D000927:Anticonvulsants