Sofia Kasradze1, Nino Gogatishvili2, Giorgi Lomidze3, Tamar Ediberidze4, Marine Lazariashvili5, Ketevan Khomeriki6, Shorena Mamukadze7, Mariam Metreveli8, Tamar Gagoshidze9, Nino Tatishvili10, Torbjörn Tomson11. 1. Epilepsy Prevention and Control Centre, Institute of Neurology and Neuropsychology, 83/11, Vazha-Pshavela Ave. 0186, Tbilisi, Georgia. Electronic address: sofiakas@gmail.com. 2. Epilepsy Prevention and Control Centre, Institute of Neurology and Neuropsychology, 83/11, Vazha-Pshavela Ave. 0186, Tbilisi, Georgia. Electronic address: nino_gogat@yahoo.com. 3. Epilepsy Prevention and Control Centre, Institute of Neurology and Neuropsychology, 83/11, Vazha-Pshavela Ave. 0186, Tbilisi, Georgia. Electronic address: lomidzegiorgi@yahoo.com. 4. Epilepsy Prevention and Control Centre, Institute of Neurology and Neuropsychology, 83/11, Vazha-Pshavela Ave. 0186, Tbilisi, Georgia. Electronic address: ediberidzet@yahoo.com. 5. Epilepsy Prevention and Control Centre, Institute of Neurology and Neuropsychology, 83/11, Vazha-Pshavela Ave. 0186, Tbilisi, Georgia. Electronic address: lazariashvilimari@ymail.com. 6. Epilepsy Prevention and Control Centre, Institute of Neurology and Neuropsychology, 83/11, Vazha-Pshavela Ave. 0186, Tbilisi, Georgia. Electronic address: kkhomeriki@yahoo.com. 7. Epilepsy Prevention and Control Centre, Institute of Neurology and Neuropsychology, 83/11, Vazha-Pshavela Ave. 0186, Tbilisi, Georgia; Iv. Javakhishvili Tbilisi State University, 1, I. Chavchavadze Ave. 0179, Tbilisi, Georgia. Electronic address: sh.mamukadze@gmail.com. 8. Epilepsy Prevention and Control Centre, Institute of Neurology and Neuropsychology, 83/11, Vazha-Pshavela Ave. 0186, Tbilisi, Georgia; Iv. Javakhishvili Tbilisi State University, 1, I. Chavchavadze Ave. 0179, Tbilisi, Georgia. Electronic address: metrmari01@gmail.com. 9. Epilepsy Prevention and Control Centre, Institute of Neurology and Neuropsychology, 83/11, Vazha-Pshavela Ave. 0186, Tbilisi, Georgia; Iv. Javakhishvili Tbilisi State University, 1, I. Chavchavadze Ave. 0179, Tbilisi, Georgia. Electronic address: gagoshidzet@gmail.com. 10. Department of Neuroscience of the Central Children Hospital, 2/6, Lubliana Str. 0159, Tbilisi, Georgia. Electronic address: n_tatishvili@hotmail.com. 11. Department of Clinical Neuroscience, Karolinska Institutet, 18A, Tomtebodavägen, 17177 Stockholm, Sweden. Electronic address: torbjorn.tomson@karolinska.se.
Abstract
OBJECTIVE: The cognitive teratogenicity of antiepileptic drugs (AEDs) has gained increasing attention in the last decade. The objective of the current study was to assess the effects of AED fetal exposure on the cognitive development of children of mothers with epilepsy from Georgia in a controlled study taking into consideration major confounding factors. METHODS: A prospective cohort group was formed from children and mothers registered in the Georgian National AED-Pregnancy Registry. The study group's age- and gender-matched control children without fetal AED exposure were selected retrospectively. The Intelligence Quotient (IQ) using the Wechsler Adult Intelligence Scale - revised (WAIS-R) was assessed in mothers. The Wechsler Preschool and Primary Scale of Intelligence (WPPSI-4) were used to assess intellectual functioning for children of both study and control groups. Linear regression analysis was performed to detect association of AED exposure on the cognitive performance of children. RESULTS: In total, 100 children aged 36 to 72months were evaluated. The IQ of WWE was significantly lower compared to women without epilepsy in all modalities. Exposure to valproate (VPA) (n=18) was associated with lowest cognitive performance regarding Full Scale IQ (FSIQ) (β, -12.04; p=0.006) and verbal comprehension (VCI) (β, -8.89; p=0.019). Maternal FSIQ, maternal performance IQ (PIQ), and child's age at first phrases were independent factors associated with the cognitive development of children. CONCLUSIONS: Multivariate analysis showed VPA to be an independent predictor for decreased cognitive performance. Maternal FSIQ, PIQ, and child developmental achievements were significant confounders for cognitive performance in children.
OBJECTIVE: The cognitive teratogenicity of antiepileptic drugs (AEDs) has gained increasing attention in the last decade. The objective of the current study was to assess the effects of AED fetal exposure on the cognitive development of children of mothers with epilepsy from Georgia in a controlled study taking into consideration major confounding factors. METHODS: A prospective cohort group was formed from children and mothers registered in the Georgian National AED-Pregnancy Registry. The study group's age- and gender-matched control children without fetal AED exposure were selected retrospectively. The Intelligence Quotient (IQ) using the Wechsler Adult Intelligence Scale - revised (WAIS-R) was assessed in mothers. The Wechsler Preschool and Primary Scale of Intelligence (WPPSI-4) were used to assess intellectual functioning for children of both study and control groups. Linear regression analysis was performed to detect association of AED exposure on the cognitive performance of children. RESULTS: In total, 100 children aged 36 to 72months were evaluated. The IQ of WWE was significantly lower compared to women without epilepsy in all modalities. Exposure to valproate (VPA) (n=18) was associated with lowest cognitive performance regarding Full Scale IQ (FSIQ) (β, -12.04; p=0.006) and verbal comprehension (VCI) (β, -8.89; p=0.019). Maternal FSIQ, maternal performance IQ (PIQ), and child's age at first phrases were independent factors associated with the cognitive development of children. CONCLUSIONS: Multivariate analysis showed VPA to be an independent predictor for decreased cognitive performance. Maternal FSIQ, PIQ, and child developmental achievements were significant confounders for cognitive performance in children.
Authors: Kimford J Meador; Page B Pennell; Ryan C May; Carrie A Brown; Gus Baker; Rebecca Bromley; David W Loring; Morris J Cohen Journal: Neurology Date: 2019-12-23 Impact factor: 9.910
Authors: Elisabeth Synnøve Nilsen Husebye; Nils Erik Gilhus; Bettina Riedel; Olav Spigset; Anne Kjersti Daltveit; Marte Helene Bjørk Journal: Neurology Date: 2018-08-01 Impact factor: 9.910