Abstracts

Rationale: The Human Epilepsy Project (HEP) is a prospective, observational study whose primary goal is to identify clinical characteristics and biomarkers predictive of disease treatment response, progression, and outcome in participants with newly treated focal epilepsy. As part of this larger investigation, cognitive data are collected to determine if they are predictive of treatment outcome, and to delineate the adverse cognitive effects of antiepileptic drug (AED) treatment and ongoing seizures. The aim of this report was to compare cognitive performance in those with vs. without secondary generalization of their seizures, as prior reports have suggested that patients with secondary generalized seizures are at greater risk for cognitive impairment. Methods: Patients with epilepsy enrolled in the HEP study underwent cognitive testing with Cogstate (online computerized test battery assessing functions such as attention, memory, and processing speed). The Cogstate battery has been shown to be sensitive to disease and drug effects. Participants in HEP completed the tests following the enrollment visit and every 3 months thereafter for the duration of their participation. The tasks included: Detection (DET), Identification (IDN), One Back Memory (ONB), One Card Learning (OCL), and Groton Maze Learning (GML). Outcome variables included speed for DET, IDN and ONB; accuracy for OCL; and total errors for the GML. The scores for those with and without secondary generalized seizures were compared via t-tests. Results: There were 67 patients without and 157 with secondary generalized seizures. The 2 groups did not differ on any of the 5 variables: DET (p=.117), IDN (p=.467), ONB (p=.448), OCL (p=.716), and GML (p=.745). See table for means and standard deviations. Conclusions: No differences in cognitive performance were observed between patients with focal epilepsy who did or did not have secondary generalized seizures. It may be that the impact of generalized seizures increases over time. Further data collection and analyses will address this potential. Funding: The Epilepsy Study Consortium (ESCI) is a non-profit organization dedicated to accelerating the development of new therapies in epilepsy to improve patient care. The funding provided to ESCI to support HEP comes from industry, philanthropy and foundations (UCB Pharma, Eisai, Pfizer, Lundbeck, Sunovian, The Andrews Foundation, The Vogelstein Foundation, Finding A Cure for Epilepsy and Seizures, Friends of Faces and others).