Abstracts

Over the last 25 years, there has been a whole host of literature investigating the effects of antiepileptic drugs (AEDs) on cognitive functioning. However, due to the design of such studies it is difficult to delineate whether cognitive impairment is a result of treatment or the effects of epilepsy per se. The SANAD study is a prospective randomised controlled trial investigating the effectiveness and cost-effectiveness of standard and novel AEDs. The neuropsychology arm provides a [italic]unique opportunity[/italic] to assess:
1. The natural history of cognitive impairment in newly diagnosed people with epilepsy (PWE)
2. The differential effects of standard and novel drugs., Using an extensive battery of neuropsychological tests, 257 patients were assessed at baseline, prior to AED medication. Of those, 204 were re-assessed after 3 months and 170 after 12 months., Interim analyses have revealed significant reductions after 12 months in psychomotor speed, as assessed by a digit cancellation task (M=44.54 [plusmn] 12.3 vs M=43.86 [plusmn] 10.55, p=0.004), and deterioration in both immediate (M= 44.19 [plusmn] 9.81 vs M= 42.72 [plusmn] 9.65, p=0.002) and delayed memory performance (M= 8.35 [plusmn] 3.36 vs M= 7.77 [plusmn] 3.08, p=0.00089) on a test of verbal learning. However, there were no differential effects of drugs., The results suggest that newly diagnosed PWE show reduced psychomotor speed and memory functioning in the twelve months after diagnosis. This study provides a [italic]unique opportunity [/italic]to understand the impact of seizures and treatment on neuropsychological profile. This study will document the natural history of cognitive impairment and provide important information about the relative risk to people with epilepsy, and what intervention is likely to be most successful.,