Abstracts

Rationale: It is a commonly held position that antiepileptic drugs (AEDs) slow patients down. For the monitoring of cognitive AED side effects computerized tests which measure psychomotor speed and alertness in milliseconds may thus be superior to paper-pencil tests which in part also have a time component. Methods: This retrospective study evaluated the performance of 55 patients with epilepsy tested with a computerized battery, NeuroCogFX, that assesses “psychomotor speed and alertness” and “cognitive processing” via 9 tasks and with EpiTrack^®, a paper-pencil test which assesses executive functions and working memory via 6 tasks. For both tests the sensitivity for individual drug-load was determined (total number of concurrent AEDs and defined daily dose (DDD)) and related to test performance and the presence/absence of drugs with known adverse psychotropic effects. Results: EpiTrack® performance correlated with the "cognitive processing" component of the NeuroCogFX but not with the "psychomotor-speed and alertness" component. Significant correlations with indices of drug-load were exclusively yielded for EpiTrack^® (number of AEDs: r = -.530, total DDD: r = -.452) and "cognitive processing" (number of AEDs: r = -.448, total DDD: r = -.415). "Psychomotor-speed and alertness" was not significantly related to drug-load (number of AEDs: r = -.271, total DDD: r = -.212) and did not change the association between EpiTrack^® and indices of drug-load when controlled for (number of AEDs: r = -.504, total DDD: r = -.427). Presence of drugs with known adverse profiles negatively affected "cognitive processing" of the computerized test. Conclusions: The results demonstrate that, although often suggested, it is less the psychomotor speed than the cognitive processing which is negatively affected by antiepileptic pharmacotherapy. The very different sensitivity to drug load questions the value of tests with a major emphasis on psychomotor speed. Funding: No funding was involved.