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Effects of the anticonvulsant topiramate on language abilities in people with epilepsy: a cross-sectional study

Published online by Cambridge University Press:  13 June 2014

Aisling Buckley*
Affiliation:
Trinity College Institute of Neuroscience, TCD, Dublin 2, Ireland
Margaret Fitzgerald
Affiliation:
Department of Neurology, St. James's Hospital, Dublin 8, Ireland
Doreen Hoerold
Affiliation:
Trinity College Institute of Neuroscience, TCD, Dublin 2, Ireland
Gavin P Davey
Affiliation:
Trinity College Institute of Neuroscience, TCD, Dublin 2, Ireland
Colin Doherty
Affiliation:
Trinity College Institute of Neuroscience, TCD, Dublin and Department of Neurology, St. James's Hospital, Dublin 8, Ireland.
*
*Correspondence E-mail: bucklea1@tcd.ie

Abstract

Objectives: The aim of this study was to investigate the effects of topiramate (TPM) on cognitive function, specifically language, in patients with epilepsy, and to determine whether a specifically designed neuropsychological test battery can show such effects.

Method: Twenty patients taking TPM, 25 epilepsy controls (taking medication other than TPM) and 25 healthy controls were recruited. We used a specific neuropsychological battery, including measures of visual and verbal memory, attention, fluency and comprehension. Separate one way between group ANOVAs were performed for each neuropsychological measure.

Results: Bonferroni comparisons revealed that the TPM group performed significantly worse than epilepsy controls on digits forward (p<0.001), digits backward (p<0.05), controlled oral word association (COWA) (p<0.05) and token test (p<0.05). The TPM group also needed more multiple choice cues in the Boston naming test (p<0.05).

Conclusions: The present study indicates that 15% of the sample tested had impaired language abilities and raises interesting questions regarding the nature of this effect. Furthermore, we have identified some short neuropsychological tasks that can be performed in routine clinical situations that can reliably identify patients who have negative linguistic effects of TPM.

Type
Original Papers
Copyright
Copyright © Cambridge University Press 2010

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References

1.Perucca, EApharmacological and clinical review of topiramate, a new antiepileptic drug. Pharmacol. Res (1997) 35(4):241256.CrossRefGoogle ScholarPubMed
2.Zaccara, G, Ganemi, PF, Cincotta, M Central nervous system adverse effects of new antiepileptic drugs: A meta-analysis of placebo-controlled studies. Seizure 2008 02 7 [Epub ahead of print].CrossRefGoogle Scholar
3.Rosenfeld, WETopiramate: A Review of Preclinical, Pharmacokinetic, and Clinical Data. Clin Ther (1997) 19(6):1294–308.CrossRefGoogle ScholarPubMed
4.Gross-Tsur, V, Shalev, RSReversible language regression as an adverse effect of topiramate treatment in children. Neurology (2004). 62(2):299300.CrossRefGoogle ScholarPubMed
5.Silberstein, SD, Neto, W, Schmitt, J, Jacobs, D; MIGR-001 Study Group Topiramate in migraine prevention: results of a large controlled trial. Arch Neurol 2004; 61(4): 490–5.CrossRefGoogle Scholar
6.Bussone, G, Diener, HC, Pfeil, J, Schwalen, STopiramate 100 mg/day in migraine prevention: a pooled analysis of double-blind randomised controlled trials. Int J Clin Pract. (2005) 59(8):961–8.CrossRefGoogle ScholarPubMed
7.Romigi, A, Cervellino, A, Marciani, MG, Izzi, F, Massoud, R, Corona, M, Torelli, F, Zannino, S, Uasone, E, Placidi, FCognitive and psychiatric effects of topiramate monotherapy in migraine treatment: an open study. Eur J Neurol. (2008) Feb; 15(2):190–5.CrossRefGoogle ScholarPubMed
8.Privitera, MD, Brodie, MJ, Mattson, RH, Chadwick, DW, Neto, W, Wang, S; EPMN 105 Study Group. Topiramate, carbamazepine and valproate monotherapy: double-blind comparison in newly diagnosed epilepsy. Acta Neurol. Scand (2003) 107:165175.CrossRefGoogle Scholar
9.Meador, KJ, Loring, DW, Hulihan, JF, Kamin, M, Karim, R; CAPSS-027 Study Group. Differential cognitive and behavioral effects of topiramate and valproate. Neurology. 2003 05 13; 60(9):1483–8.CrossRefGoogle Scholar
10.Kockelmann, E, Elger, CE, Helmstaedter, C.Cognitive profile of topiramate as compared with lamotrigine in epilepsy patients on antiepileptic drug polytherapy: relationships to blood serum levels and comedication. Epilepsy Behav 2004; 5(5):716–21.CrossRefGoogle Scholar
11.Brown, CM, Hagoort, P, The Neurocognition of Language (1999) 1st Ed. Pg 216Google Scholar
12.Fritz, N, GloGlogau, S, Hoffmann, J, Rademacher, M, Elger, CE, Helmstaedter, CEfficacy and cognitive side effects of tiagabine and topiramate in patients with epilepsy. Epilepsy Behav. (2005);6(3):373–81.CrossRefGoogle ScholarPubMed
13.Ojemann, LM, Ojemann, GA, Dodrill, CB, Crawford, CA, Holmes, MD, Dudley, DLLanguage Disturbances as Side Effects of Topiramate and Zonisamide Therapy Epilpesy Behav. (2001) 2(6): 579584.Google Scholar
14.Mula, M, Trimble, MR, Thompson, P, Sander, JWTopiramate and word-finding difficulties in patients with epilepsy. Neurology. (2003) 60(7):1104–7.CrossRefGoogle ScholarPubMed
15.Strauss, E, Sherman, E, Spreen, O, A Compendium of Neuropsychological Tests 3rd Ed. (2006) Pgs 100, 547,811.Google Scholar
16.Coppola, F; Rossi, C; Mancini, ML, Corbelli, I; Nardi, K; Sarchielli, P; Calabresi, P.Language Disturbances as a Side Effect of Prophylactic Treatment of Migraine. Headache; (2008) 48:8694.CrossRefGoogle ScholarPubMed
17.Marino, SE, Meador, KJ, Loring, DW, Okun, MS, Fernandez, HH, Fessier, AJ, Kustra, RPJ.M., Miller f, P.G., Ray g, A., Roy h, M.R., Schoenberg i, V.J., Vahle j, M.A., WerzSubjective perception of cognition is related to mood and not performance. Epilepsy & Behaviour (2009)14, 459464.CrossRefGoogle Scholar
18.De Ciantis, A, Muti, M, Piccolini, C, Principi, M, Di Renzo, A, De Ciantis, R, Frondizi, D, lannone lannone, G, Ottaviano, P, Piccirilli, MA functional MRI study of language disturbances in subjects with migraine headache during treatment with topiramate Neurol Sci (2008) 29:S141S143.Google Scholar