Abstracts

Prior studies have suggested that subjective and objective cognitive effects of antiepileptic drugs (AEDs) are poorly associated. This study examined the relationship of subjective perception of cognitive effects to actual objective cognitive performance in a study of healthy volunteers taking lamotrigine (LTG) or topiramate (TPM). This was a randomized, double-blind, two-period crossover study of 47 (19 men and 28 women; mean age = 37 years) healthy adults who completed both phases of the study. Each drug was given for 12 weeks (7 weeks of dose escalation followed by 4 weeks of maintenance, and then 1 week taper). Initial dose was 25mg/day, and target maintenance dose was 300mg/day for both drugs. Neuropsychological evaluations were conducted at Screening, end of First and Second Maintenance Phase, and Post-treatment Period. This analysis included 33 variables across 14 measures: Selective Reminding Test, MCG Paragraph Memory, Boston Naming Test, Animal Naming, Controlled Oral Word Association, Stroop Test, Symbol Digit Modalities Test, Digit Cancellation, Grooved Pegboard, Choice Reaction Time, Visual Serial Addition Test (VSAT), Continuous Performance Task, Profile of Mood States (POMS), and QOLIE-89 cognitive subscales (i.e., subjective perception of Attention, Language and Memory). Bivariate correlations were run for each of the QOLIE-89 cognitive subscales vs. the other neuropsychological variables. Significant correlations (p[lt].01 with r values ranging from [underline]+[/underline] .304 to .819) were present for QOLIE Memory to POMS (TPM for Vigor, Fatigue and Total; LTG for Depression, Anger, Fatigue, Confusion and Total); QOLIE Attention to POMS (TPM for Vigor, Fatigue, Confusion, and Total; LTG for all 6 POMS subscales and Total score); and QOLIE Language to POMS (TPM for Tension, Vigor, Fatigue, Confusion and Total; LTG for Depression, Anger, Vigor, Fatigue, Confusion, and Total). The only significant correlation of QOLIE cognitive subscales to objective measures was for QOLIE Language to trials 1, 3, 4 and the total score of the VSAT for LTG. Subjective perception of AED cognitive effects is more related to mood than actual objective performance. Clinicians should consider this factor in assessment of patient complaints concerning cognitive function. (Supported by Glaxo SmithKline.)