. The effects of topiramate on cognitive functions of patients with focal epilepsy – a folow-up study in a Serbian sample

Abstract

Introduction/Objective Theaimof thisfollow-upstudywasto determinetheeffectsoftopiramate therapyoncognitive functionsinpatients withpharmacoresistant focalepilepsy. MethodsThestudysamplecomprised of40topiramate naivepatients. Thetopiramate startingdose was25mg,withafortnightly titrationschedule of 25mg.A widerangeofcognitive functions was evaluated tlllph extensive neuropsychological testingatbaseline andsixmonthsafterreaching the target dose(200mg/day). ResultsThemost-common sideeffectsfollowingtheintroductionoftopiramatewerecognitiveimpairments, reportedby45Voofthe participants.The neuropsycholcgical scoreson attention, executive function, verbal content recall, improvedcognitive flexibiliiy, aswellasvisuospatial abilityandspeech, obtained atsix-month follow-up weresignificantly lowerthan atbaseline. However, statistically significant correlation betweenneuropsychologicil scores andthenumber ofantiepileptic Orrqrt.["] ,6rgiid" topiramate couldnotbeestablished. Similarly, nostatistically significant differences werenotedbetween thepercentage ofreducedneuropsychological scores atfollow-uppertainingto patientswithlower andhigherbaseline cognitiveperformance. Moreover, regression analysis indicates thatthepercentagechangeinthemajorityof cognitivescoresisunrelated to theageattheepilepsy onset, epilepsy duration, presence of brainpathology onmagnetic resonance imagingandpercentage changeinthe depression scalescore. Conclusion Despite slowintroduction andadministration ofarelatively small dose, topiramate exhibits adverse effectsonawiderangeofcognitive functions, whichappear unrelated to thenumber ofadditionalantiepileptic drugs, baseline cognitive functioning, ageattheonsetofepilepsy anditsduration, presence ofbrainpathology andtheextentofdepressive symptom