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首页> 外文期刊>European journal of neurology: the official journal of the European Federation of Neurological Societies >Impaired verbal fluency under topiramate - evidence for synergistic negative effects of epilepsy, topiramate, and polytherapy
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Impaired verbal fluency under topiramate - evidence for synergistic negative effects of epilepsy, topiramate, and polytherapy

机译：托吡酯下的语言流利度受损-癫痫，托吡酯和多药疗法协同负面作用的证据

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Background and purpose: Treatment with topiramate (TPM) is known to negatively affect executive functions and verbal fluency in particular. However, judgments of cognitive side effects under TPM rarely consider clinical conditions and possible effects of epilepsy, treatment, and drug load. Methods: This retrospective cross-sectional study in large cohorts of patients with epilepsy evaluated the impact of TPM mono- and polytherapy on verbal fluency. To isolate TPM-induced effects from those of epilepsy and antiepileptic medication in general, verbal fluency under TPM (N = 421) was compared to the performance of a matched sample of patients with an antiepileptic medication other than TPM (N = 351), untreated patients (N = 108), and healthy controls (N = 100). Results: Impaired verbal fluency performance was seen in 77% of the patients treated with TPM. Compared to healthy controls, verbal fluency in untreated patients was reduced by 22%, under monotherapy without TPM by 31% and under TPM monotherapy by 45%. With and without TPM, verbal fluency performance linearly decreased with each additional drug in polytherapy. On each level, performance under TPM was 21-28% worse than in the respective condition without TPM. Unimpaired performance under TPM was primarily associated with lower dose, higher education, and a later onset of epilepsy. Conclusions: The majority of patients under TPM shows reduced verbal fluency. However, when taking the cumulative negative effects of epilepsy, and the concomitant drug regimen into account, TPM is associated with a 21-28% poorer performance as compared with other drugs. Additionally, the data indicate an impact of dose and reserve capacity on the occurrence of impairments.
机译：背景和目的：已知托吡酯（TPM）的治疗会对执行功能和言语流畅性产生负面影响。但是，在TPM下对认知副作用的判断很少考虑临床情况以及癫痫，治疗和药物负荷的可能影响。方法：这项回顾性横断面研究在大批癫痫患者中评估了TPM单药和多药疗法对口语流利度的影响。为了从癫痫药和抗癫痫药中分离出TPM诱导的作用，通常将TPM下的语言流利度（N = 421）与未经治疗的非TPM的抗癫痫药患者的匹配样本（N = 351）的性能进行比较患者（N = 108）和健康对照（N = 100）。结果：在接受TPM治疗的患者中，有77％的语言流畅度表现受损。与健康对照相比，未经治疗的患者的口语流利性降低了22％，在没有TPM的单药治疗下降低了31％，在TPM的单药治疗下降低了45％。使用和不使用TPM，多药治疗中每增加一种药物，口语流利度都会线性下降。在每个级别上，TPM下的性能都比不使用TPM的情况下的性能低21-28％。 TPM下无双的表现主要与较低的剂量，较高的受教育程度和较晚的癫痫发作有关。结论：大多数接受TPM治疗的患者言语流利性降低。但是，考虑到癫痫病的累积负面影响以及伴随的药物治疗方案，与其他药物相比，TPM的治疗效果差21-28％。另外，数据表明剂量和储备容量对损伤发生的影响。

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