Abstracts

Rationale: Patients with a history of seizures who are treated with antiepileptic drugs typically present with complaints of side effects of cognitive impairment and/or worsening quality of life. The most common side effects involve sedation, distractibility, inattention, cognitive slowing, and memory problems. Previous clinical trials of the antiepileptic medication lacosamide (brand name Vimpat) have suggested minimal cognitive impairment. This study examined the impact of lacosamide on patients with partial epilepsy in terms of cognitive and behavioral side effects, both percieved and objective measures. Methods: Patients had a history of refractory partial onset epilepsy, with a mean seizure frequency of greater than or equal to 2 seizures per month, on average during the 6 months prior to participation in the study. Patients had no history of drug/alcohol abuse, psychiatric disorder, progressive, demyelinating, or degenerative neurological condition, psychogenic seizures, traumatic brain injury, or cardiac arrhythmia. Patients underwent neuropsychological testing on two occasions, six months apart, for comparisons of objective and subjective measures. These measures included: BDI-II, POMS, QOLIE-89, COWAT, Buschke Selective Reminding Test, BVMT-R, Stroop Color Word Test, Symbol Digit Modalities Test, Digit Span, Digit Cancellation, Connor's Continuous Performance Test, Trails A, and Trails B. At the time of this first review of data, 8 patients had completed the two testing sessions for comparison. Mean age was 36.6, with a range of 18 to 58 years. Education level included 1 with less than high school, 2 with high school or GED, 0 with some college, and 2 college degrees. Ethnicities included 3 Caucasian, 3 Black, and 4 Other (1 identified as Hispanic). There were 5 males and 3 females. Results: Differences between scores on the various measures were computed used paired samples t-tests using the SPSS statistics program. No significant differences were noted on any of the objective measures suggesting no significant changes on measures of verbal fluency, verbal learning, non-verbal memory, cognitive inhibition, cognitive speed, visuo-motor speed, attention, concentration, sustained concentration, psychomotor speed, psychomotor alternation. Likewise, no significant differences were noted on any of the subjective measures suggesting no significant changes in terms of mood (particularly depression symptomology), anxiety, level of energy, or quality of life (including subjective assessments of cognitive functioning). Conclusions: These findings are encouraging regarding the use of lacosimide as an AED. Patients with a history of seizures being treated with AEDs typically present with complaints of side effects, most notably for attention and memory. These findings suggest that lacosimide may be particularly beneficial for patients with epilepsy given the lack of findings of significant change neither positive or negative - regarding cognitive and behavioral functioning.