دورية أكاديمية
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Which is more deleterious to cognitive performance? Interictal epileptiform discharges vs anti-seizure medication.

التفاصيل البيبلوغرافية
العنوان: Which is more deleterious to cognitive performance? Interictal epileptiform discharges vs anti-seizure medication.
المؤلفون: Warsi NM; Division of Neurosurgery, Hospital for Sick Children, Toronto, Ontario, Canada.; Institute of Biomedical Engineering, University of Toronto, Toronto, Ontario, Canada., Wong SM; Institute of Biomedical Engineering, University of Toronto, Toronto, Ontario, Canada.; Program in Neuroscience and Mental Health, Hospital for Sick Children, Toronto, Ontario, Canada., Gorodetsky C; Division of Neurosurgery, Hospital for Sick Children, Toronto, Ontario, Canada.; Division of Neurology, Hospital for Sick Children, Toronto, Ontario, Canada., Suresh H; Division of Neurosurgery, Hospital for Sick Children, Toronto, Ontario, Canada.; Institute of Biomedical Engineering, University of Toronto, Toronto, Ontario, Canada., Arski ON; Program in Neuroscience and Mental Health, Hospital for Sick Children, Toronto, Ontario, Canada., Ebden M; Program in Neuroscience and Mental Health, Hospital for Sick Children, Toronto, Ontario, Canada., Kerr EN; Program in Neuroscience and Mental Health, Hospital for Sick Children, Toronto, Ontario, Canada., Smith ML; Program in Neuroscience and Mental Health, Hospital for Sick Children, Toronto, Ontario, Canada., Yau I; Division of Neurology, Hospital for Sick Children, Toronto, Ontario, Canada., Ochi A; Division of Neurology, Hospital for Sick Children, Toronto, Ontario, Canada., Otsubo H; Division of Neurology, Hospital for Sick Children, Toronto, Ontario, Canada., Sharma R; Division of Neurology, Hospital for Sick Children, Toronto, Ontario, Canada., Jain P; Division of Neurology, Hospital for Sick Children, Toronto, Ontario, Canada., Weiss S; Division of Neurology, Hospital for Sick Children, Toronto, Ontario, Canada., Donner EJ; Division of Neurology, Hospital for Sick Children, Toronto, Ontario, Canada., Snead OC; Division of Neurology, Hospital for Sick Children, Toronto, Ontario, Canada., Ibrahim GM; Division of Neurosurgery, Hospital for Sick Children, Toronto, Ontario, Canada.; Institute of Biomedical Engineering, University of Toronto, Toronto, Ontario, Canada.; Program in Neuroscience and Mental Health, Hospital for Sick Children, Toronto, Ontario, Canada.
المصدر: Epilepsia [Epilepsia] 2023 May; Vol. 64 (5), pp. e75-e81. Date of Electronic Publication: 2023 Mar 09.
نوع المنشور: Journal Article; Research Support, Non-U.S. Gov't
اللغة: English
بيانات الدورية: Publisher: Blackwell Science Country of Publication: United States NLM ID: 2983306R Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1528-1167 (Electronic) Linking ISSN: 00139580 NLM ISO Abbreviation: Epilepsia Subsets: MEDLINE
أسماء مطبوعة: Publication: Malden, MA : Blackwell Science
Original Publication: Copenhagen : Munskgaard
مواضيع طبية MeSH: Epilepsy*/complications , Epilepsy*/drug therapy , Epilepsies, Partial*/complications , Epilepsies, Partial*/drug therapy , Drug Resistant Epilepsy*/complications, Child ; Humans ; Electroencephalography/methods ; Cognition/physiology
مستخلص: Children with epilepsy commonly have comorbid neurocognitive impairments that severely affect their psychosocial well-being, education, and future career prospects. Although the provenance of these deficits is multifactorial, the effects of interictal epileptiform discharges (IEDs) and anti-seizure medications (ASMs) are thought to be particularly severe. Although certain ASMs can be leveraged to inhibit IED occurrence, it remains unclear whether epileptiform discharges or the medications themselves are most deleterious to cognition. To examine this question, 25 children undergoing invasive monitoring for refractory focal epilepsy performed one or more sessions of a cognitive flexibility task. Electrophysiological data were recorded to detect IEDs. Between repeated sessions, prescribed ASMs were either continued or titrated to <50% of the baseline dose. Hierarchical mixed-effects modeling assessed the relationship between task reaction time (RT), IED occurrence, ASM type, and dose while controlling for seizure frequency. Both presence (β ± SE = 49.91 ± 16.55 ms, p = .003) and number of IEDs (β ± SE = 49.84 ± 12.51 ms, p < .001) were associated with slowed task RT. Higher dose oxcarbazepine significantly reduced IED frequency (p = .009) and improved task performance (β ± SE = -107.43 ± 39.54 ms, p = .007). These results emphasize the neurocognitive consequences of IEDs independent of seizure effects. Furthermore, we demonstrate that inhibition of IEDs following treatment with select ASMs is associated with improved neurocognitive function.
(© 2023 International League Against Epilepsy.)
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فهرسة مساهمة: Keywords: anti-seizure medication; attention; cognitive deficits; epilepsy; interictal discharge
تواريخ الأحداث: Date Created: 20230222 Date Completed: 20230511 Latest Revision: 20230514
رمز التحديث: 20230515
DOI: 10.1111/epi.17556
PMID: 36809544
قاعدة البيانات: MEDLINE
الوصف
تدمد:1528-1167
DOI:10.1111/epi.17556