title: Cognitive and behavioral outcomes among seizure-controlled children with partial epilepsy on antiepileptic drug monotherapy.
abstract: The objective of this study was to assess cognitive performance and behavioral symptoms in a sample of children diagnosed with partial epilepsy who were seizure controlled on AED monotherapy for one year. Ninety-eight seizure-controlled children on AED monotherapy were included in this study. Specific AEDs examined included topiramate, divalproex sodium, lamotrigine, levetiracetam, and oxcarbazepine. Groups did not differ on age, region of focal epilepsy, or Full-Scale IQ. Direct measures included the WISC-IV and selected tests from the DKEFS (Verbal Fluency and Trail Making Test). Parent report measures included the BRIEF and the BASC-PRS. A series of ANOVAs revealed significant differences across the AED cohorts within many domains of cognitive functioning and behavioral presentation. Children prescribed divalproex sodium or topiramate demonstrated weaker working memory and verbal fluency, when compared with children prescribed other AEDs. Additionally, parents of children prescribed topiramate reported greater executive functioning and adaptive skills deficits. The pattern of findings suggests that children prescribed divalproex sodium or topiramate generally demonstrated a higher risk of cognitive and behavioral impairments compared to the other AEDs. Future prospective studies are required in order to better understand the relationship between AED type and these outcomes to inform clinical practice.
authors: a Children's Healthcare of Atlanta , Atlanta , Georgia , USA.
authors: Thomas G
authors: http://orcid.org/0000-0003-3719-653X
authors: TG
authors: Burns
authors: b Department of Psychology , Georgia State University , Atlanta , Georgia , USA.
authors: Natasha N
authors: NN
authors: Ludwig
authors: c Georgia School of Professional Psychology , Atlanta , Georgia , USA.
authors: Tiffany N
authors: TN
authors: Tajiri
authors: c Georgia School of Professional Psychology , Atlanta , Georgia , USA.
authors: Nick
authors: N
authors: DeFilippis
mesh_terms: D000293:Adolescent; D000927:Anticonvulsants / Q000009:adverse effects*; D002648:Child; D002653:Child Behavior Disorders / Q000139:chemically induced*; D003072:Cognition Disorders / Q000139:chemically induced*; D004828:Epilepsies, Partial / Q000188:drug therapy* / Q000503:physiopathology / Q000523:psychology; D056344:Executive Function / Q000187:drug effects; D005260:Female; D006801:Humans; D007361:Intelligence Tests; D008297:Male; D008570:Memory, Short-Term / Q000187:drug effects; D009483:Neuropsychological Tests; D010290:Parents / Q000523:psychology; D011597:Psychomotor Performance / Q000187:drug effects; D016896:Treatment Outcome; D014705:Verbal Behavior / Q000187:drug effects
chemical_list: D000927:Anticonvulsants
keywords: Divalproex sodium; executive functioning; lamotrigine; levetiracetam; oxcarbazepine; pediatrics; topiramate