The Effects Of Topiramate And Sodium Valproate Retard Tablet On Cognitive Function In Adult With Epilepsy

Objective:To evaluate the effects of topiramate(TPM)and sodium valproate retard tablet(VAP)on cognitive function in adult patients with epilepsy.methods:62 adult patients,newly diagnosed as epilepsy,were randomly divided into 2 groups:TPM Group(n=30):patients were only treated with monotherapy of TPM; VAP Group(n=32):patients were only treated with VAP.The cognitive function of all the patients in these two groups were evaluated by the Revised Adult Wechsler memory scale(WMS-RC)and event related potentials(ERPs)before treatment and two months after administration of TPM/VAP.In addition,the effects of TPM and VAP on patients with epilepsywere also compared.Results:1.Before administration of TPM:Memory Quotient(MQ)in 8 patients＜100, accounting for 26.67%;In the ERPs,the P₃ wave latency in 10 patients＞357.1ms, accounting for 33.33%.Before administration of VAP:Memory Quotient(MQ)in 9 patients＜100,accounting for 28.0%;In the ERPs,the P₃ wave latency in 10 patients＞357.1ms,accounting for 31.25%.There was not significant difference between these two groups with respect to the cognitive function(P＞0.05).2.Two months after administration of TPM/VAP:in TPM Group and VAP Group,the total efficacy of TPM on controling the seizure of epilepsy was 80%and 78.1% respectively.There was not significant difference between these two groups with respect to the total efficacy(P＞0.05). 3.After administration of TPM,in TPM Group the score of sequence counts of 1 to 100 declined(P＜0.01),the score of sequence counts of 100 to 1 declined(P＜0.05), the score of digit cumulate cognitive function declined(P＜0.05),the mistakes of cards recognition increased(P＜0.01),the function of cards remembrance declined (P＜0.01),the mistakes of cards reclamation increased(P＜0.01),the mistakes of word association increased(P＜0.01),the object touch was more difficult(P＜0.01),the function of story apprehension declined(P＜0.01)and the natural order and anti-natural order repeat of digit were more difficult(P＜0.01).In the ERPs, the N₁ wave latency prolonged(P＜0.05)and the P₂,N₂,P₃ waves latencies all prolonged significantly(P＜0.01),while the amplitude of P₃ wave declined(P＜0.01). In VAP Group:the score of WMS-CR TEST in every item did not change significantly(P＞0.05).In the ERPs,the N₁ wave latency shortened(P＜0.05)and the P₂,N₂,P₃ waves latencies all shortened significantly(P＜0.01),while the amplitude of P₃ wave did not increase significantly(P＞0.05).4.After administration of TPM/VAP,there were significant differences between these two groups with respect to 13 parameters,which are sequence counts of 1 to 100(P＜0.01),sequence counts of 100 tol(P＜0.01),digit cumulate cognitive function(P＜0.01),cards recognition(P＜0.01),cards remembrance(P＜0.01),cards reclamation(P＜0.01),word association(P＜0.01),object touch(P＜0.01),story apprehension(P＜0.01)and natural order and anti-natural order repeat of digit(P＜0.01).MQ(P＜0.01);Inthe ERPs,the P₃ wave latency(P＜0.01)and amplitude of P₃ wave(P＜0.01).5.The short memory of WMS-RC was reversely correlated with the P₃ wave latency (P＜0.05).Conclusions:1.Both TPM and VAP are ideal antiepileptic drugs on controling the seizure of epilepsy;2.After administrateration of TPM,patients with epilepsy who are in the drug titration phase are more likely to suffer from many cognitive disturbers;3.When the dose of VAP is in normal blood drug level,patients' cognitions are not impaired but improved by administration of VAP; 4.The short memory of WMS-RC was reversely correlated with the P₃ wave latency, so the cognitive functions of patients with epilepsy may be evaluated by ERPs combined with WMS-RC.After examination of ERPs and WMS-RC,the results of evaluation of cognitive function will be more objective and comprehensive.