Abstracts

Cognitive side effect is a possible effect of topiramate (Perez-Alvarez et al. Epilepsia 2002; 43 Suppl.8: 187). Cognitive function is not unanimously defined. Furthermore, the euthimic effect of topiramate on impulsive dysfunction is known. Aims: To asses the cognitive effect of topiramate with a modern battery, Das-Naglieri Cognitive Assessment System (Chicago,IL: Riverside Publising; 1997). Also, to test the influence of topiramate on behavior (Ho [amp] Dong. Korean Pediatric Topiramate Study Group. Epilepsia 2004; 45 Suppl. 7: 350-1)., As a prospective study, 40 patients, 5 to 15 years old, with idiopathic or cryptogenic epilepsies - ILAE criteria - with normal MRI were randomly recruited. Rolandic epilepsy was excluded. The TPM dose: 1^st week, 1 mg/kg/day; 2^nd week, 2 mg/kg/day; 3^rd -4^th weeks, 3 mg/kg/day, and 5^th and following weeks, 4 mg/kg/day. They were administered DN:CAS battery and behavioral questionnaires [Eyberg Child Behabior Inventory for parents (ECBI) + Conners Parent Symptom Questionaire (PSQ) + Achenbach Child Behavior Checklist for parents (CBCL/4-18)] at baseline, and after 6 and 12 months on topiramate. Cognitive scores were compared to those of healthy controls (n=320), pertaining to the DN:CAS validation in Spanish population, at baseline, and baseline scores were compared to 6 and 12 months follow-up scores. t-Student was applied., Patient DN: CAS scores (83.95 [plusmn] 11.14) were lower in successive processing before treatment as compared to controls ( 93.76 [plusmn] 15.78; t = 3.64, p [lt] 0.001). After 6 months no change was noted. After 12 months, patients scored significantly better ( 99.93 [plusmn] 12.83 ) in DN:CAS planning than before treatment ( 94.66 [plusmn] 11.72; t = 2.47, p = 0.04). Statistically significant differences between at baseline and 12 moths later were also found in behavioral tests: ECBI ( PTI 33.5 [plusmn] 4.18 versus 26.2 [plusmn] 3.18; t = 23.65, p [lt] 0.0001 and PTP 15.1 [plusmn] 3.02 versus 12.6 [plusmn] 2.06; t = 9.76, p [lt] 0.0001); PSQ ( 7.2 [plusmn] 3.9 versus 4.7 [plusmn] 2.7; t = 5.63, p [lt] 0.0001). In CBCL, externalizing aggression and delinquent and internalizing withdrawn parameters showed higher scored at baseline than 12 months later( P [lt] 0.001)., Successive processing (memory working) dysfunction not related with topiramate was found. Improved planning processing and behavioral pattern were observed 12 months after treatment. According to the euthimic effect of topiramate and the neurocognitive-neuroimpulsive interaction (Perez-Alvarez et al. An fMRI study of emotional engagement in decision-making. TAR 2006; 2:48-51), positive effect of topiramate on DN:CAS and behavior can be postulated (Eun et al. Epilepsia 2004; 45 Suppl. 7: 288-9). Studies with longer samples as that of the Partners In Epilepsy (PIE) European group, of which we are members, are needed., (Supported by Girona University.)