Authors :
Presenting Author: Christoph Helmstaedter, PhD – University Clinic of Bonn
Sarah Al-Haj-Mustafa, MSc. – Department of Epileptology, University of Bonn Medical Center, Bonn, Germany
Randi von Wrede, PD Dr.med – Department of Epileptology, University of Bonn Medical Center, Bonn, Germany
Jur-Alexander Witt, PhD – University Clinic Bonn
Rationale:
Dependent on substance and drug load, antiseizure medication (ASM) bears the risk of negative cognitive side effects. Preferentially attention and executive functions are affected thereby affecting in addition other cognitive domains and developments, which rely on these functions. We evaluated the hypothesis that better education and higher intelligence levels have a protective effect because greater reserve capacities to cope and compensate side effects can be expected.
Methods:
This retrospective controlled study evaluated drug load effects on executive functions as dependent on education and IQ in 1640 patients with epilepsy. 48% of the patients were female, the average age 40 +/- 15 yrs., and 10%/30%/42%/15%/3% were on 0/ 1/2/3/4 drugs. Executive functions were assessed by the EpiTrack, a measure which is sensitive to ASM and frontal lobe dysfunction. IQ was assessed by a knowledge based vocabulary test (MWT-B) and in about one third of the patients also with a short WAIS-R form.
Results:
EpiTrack indicated impairement in 44% of the patients, IQ was below 85 points in 9%, education less than 10 years in 29%. Drug load correlated to the EpiTrack with -0.28, p< 0.001, and not different dependent on education or intelligence. EpiTrack correlated to vocabulary IQ with 0.36, p< 0.001 and to the WAIS-R with 0.55, p< 0.001 The more educated/intelligent had significantly better executive functions than the less educated/intelligent and performance in both groups tended to be worse with each additional anti-seizure drug (F 12.3 to 90.0, p< 0.001). No interaction effects were observed. On an individual level, drug load differentiated poorer in the less intelligent.