Foetal Antiepileptic Drug Exposure and Verbal versus Non-Verbal Abilities at Three Years of Age

Autor/inn/en	Meador, Kimford J.; Baker, Gus A.; Browning, Nancy; Cohen, Morris J.; Clayton-Smith, Jill; Kalayjian, Laura A.; Kanner, Andres; Liporace, Joyce D.; Pennell, Page B.; Privitera, Michael; Loring, David W.
Titel	Foetal Antiepileptic Drug Exposure and Verbal versus Non-Verbal Abilities at Three Years of Age
Quelle	In: Brain, 134 (2011) 2, S.396-404 (9 Seiten) PDF als Volltext Verfügbarkeit
Sprache	englisch
Dokumenttyp	gedruckt; online; Zeitschriftenaufsatz
ISSN	0006-8950
DOI	10.1093/brain/awq352
Schlagwörter	Epilepsy; Seizures; Intelligence Quotient; Preschool Children; Neonates; Verbal Ability; Drug Therapy; Nonverbal Ability; Pregnancy; Females; Foreign Countries; Comparative Analysis; Measures (Individuals); Psychomotor Skills; Correlation; Lateral Dominance; Risk; United Kingdom; United States; Peabody Picture Vocabulary Test + Suchen Sie Ihr Suchwort? Epilepsie; Anfallsleiden; Intelligenzquotient; Pre-school age; Preschool age; Child; Children; Pre-school education; Preschool education; Vorschulalter; Kind; Kinder; Vorschulkind; Vorschulkinder; Vorschulerziehung; Vorschule; Neugeborenes Kind; Mündliche Leistung; Schwangerschaft; Weibliches Geschlecht; Ausland; Messdaten; Psychomotorische Aktivität; Korrelation; Hemisphärendominanz; Risiko; Großbritannien; USA
Abstract	We previously reported that foetal valproate exposure impairs intelligence quotient. In this follow-up investigation, we examined dose-related effects of foetal antiepileptic drug exposure on verbal and non-verbal cognitive measures. This investigation is an ongoing prospective observational multi-centre study in the USA and UK, which has enrolled pregnant females with epilepsy on monotherapy from 1999 to 2004. The study seeks to determine if differential long-term neurodevelopmental effects exist across four commonly used drugs (carbamazepine, lamotrigine, phenytoin and valproate). This report compares verbal versus non-verbal cognitive outcomes in 216 children who completed testing at the age of three years. Verbal and non-verbal index scores were calculated from the Differential Ability Scales, Preschool Language Scale, Peabody Picture Vocabulary Test and Developmental Test of Visual-Motor Integration. Verbal abilities were lower than non-verbal in children exposed in utero to each drug. Preconceptional folate use was associated with higher verbal outcomes. Valproate was associated with poorer cognitive outcomes. Performance was negatively associated with valproate dose for both verbal and non-verbal domains and negatively associated with carbamazepine dose for verbal performance. No dose effects were seen for lamotrigine and phenytoin. Since foetal antiepileptic drug exposure is associated with lower verbal than non-verbal abilities, language may be particularly susceptible to foetal exposure. We hypothesize that foetal drug exposure may alter normal cerebral lateralization. Further, a dose-dependent relationship is present for both lower verbal and non-verbal abilities with valproate and for lower verbal abilities with carbamazepine. Preconceptional folate may improve cognitive outcomes. Additional research is needed to confirm these findings, extend the study to other drugs, define the risks associated with drug treatment for seizures in the neonates, and understand the underlying mechanisms. (As Provided).
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Erfasst von	ERIC (Education Resources Information Center), Washington, DC
Update	2017/4/10