Abstracts

The antiepileptic drug may cause decrease in cognitive functions in epilepsy patients, although it reduces the frequency and the intensity of seizures. The aim of this study was to evaluate the effect of topiramate (TPM) on cognition., Twelve heterogeneous epilepsy patients (7 men, mean age: 32.2[plusmn]12.9 years) had repeated neuropsychological tests including various cognitive domains before and after TPM medication. The duration of TPM administration ranged from 123 to 271 days (mean duration: 192.4[plusmn]36.6 days). The mean TPM dose at the time of post-TPM neuropsychological test was 150.0[plusmn]101.7 mg (range: 50-400mg)., Paired [italic]t[/italic]-test between pre- and post-TPM scores showed significant decreases in digits span forward ([italic]p [/italic]= 0.005), digits span backward ([italic]p [/italic]= 0.003), Corsi block test forward ([italic]p [/italic]= 0.016), Corsi block backward ([italic]p[/italic] = 0.008) and the Controlled Oral Word Association (COWA) phonemic word fluency test ([italic]p[/italic] = 0.020) and marginally significant decrease in COWA category fluency test ([italic]p[/italic] = 0.078), which indicate decline in attention, working memory, and frontal executive function by TPM administration. However, the changes of other tests such as K-MMSE, FSIQ (short form), Digit symbol test, K-CVLT, Rey complex figure test, WCST, K-BNT, Raven[apos]s colored progressive matrices, Stroop test, TMT, and Beck depression inventory were not significant by TPM. the analysis between daily dose of TPM and differences in the neuropsychological scores (post-TPM score minus pre-TPM score) showed that WCST (Wisconsin card sorting test) perseverative errors were positively correlated with the TPM dose ([italic]r [/italic]= 0.765, [italic]p[/italic] = 0.004), indicating that higher TPM dosage were related to more decrease in frontal lobe function. It was found that CVLT recognition ([italic]r [/italic]= -0.767, [italic]p[/italic] = 0.006) and Rey copy ([italic]r [/italic]= -0.703, [italic]p[/italic] = 0.016) were negatively correlated with age after controlling TPM dose., Frontal executive function was decreased in the epilepsy patients treated with TPM monotherapy. TPM[apos]s detrimental effect on frontal lobe function was positively correlated with TPM daily dose. These results suggested that TPM may more decrease verbal memory and visuospatial functions in the older patients.on,