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• W2320137981 abstract "Objective: Determine if differential long-term neurodevelopmental effects exist across commonly used antiepileptic drugs (AEDs). Background The primary outcome (age 6 year IQ) of the NEAD study and other cognitive findings at this age are reported here. Preliminary findings at age 3 were previously reported (Meador et al. NEJM 2009). Design/Methods: Pregnant women with epilepsy on AED monotherapy (carbamazepine, lamotrigine, phenytoin, or valproate) were enrolled in a prospective observational multicenter study in the USA and UK from 1999-2004. Multivariate analyses were conducted on intent-to-treat (n=310) and completer samples (n=224) with appropriate follow up analyses and secondary analyses of other cognitive measures. Results: Children exposed to valproate (adjusted mean IQ = 99) had significantly lower IQ scores than children in each of the other AED groups (carbamazepine = 105, lamotrigine = 108, phenytoin = 106). Children in the valproate group also performed more poorly vs. each of the other three AEDs on measures of verbal abilities and memory, and more poorly vs. lamotrigine on measures of non-verbal and executive functions. Valproate dose was negatively associated with IQ, verbal, non-verbal, memory, and executive functions, but the other AEDs did not demonstrate a dose relationship. Age 6 IQ correlated positively with IQ at earlier ages, and IQ scores improved with age across all AEDs. Verbal abilities were impaired compared to non-verbal abilities for all AEDs combined and for each individual AED except phenytoin. Children exposed to peirconception folate exhibited higher IQ (108 vs. 102 for those not receiving folate). Conclusions: Fetal valproate exposure is associated with lower IQ and reduced cognitive abilities across a range of cognitive domains at age 6 years. Verbal abilities may be impaired by several commonly used AEDs. Periconceptional folate may have positive effects on cognitive outcomes. Many unanswered questions remain, and additional research is needed. Supported by: NIH [NS038455 and NS050659] and UK Epilepsy Research Foundation [RB219738]. Disclosure: Dr. Meador has received research support from Cyberonics, Neuropace, Pfizer, and UCB Pharma. Dr. Baker has received personal compensation for activities with UCB as a speaker. Dr. Baker has received research support from UCB and Sanofi Aventis. Dr. Browning has nothing to disclose. Dr. Cohen has received personal compensation for activities with the Children9s Memory Scale. Dr. Brombley has received personal compensation for activities with Sanofi-Aventis Pharmaceuticals, Inc. Dr. Brombley has received research support from Sanofi-Aventis Pharmaceuticals, Inc. Dr. Clayton-Smith has received personal compensation in an editorial capacity for Clinical Dysmophology. Dr. Kalayjian has received personal compensation for activites with GlaxoSmithKline as a speaker. Dr. Kanner has received research support from Pfizer Inc. Dr. Liporace has received personal compensation for activities with UCB Pharmaceuticals as a speaker. Dr. Pennell has nothing to disclose. Dr. Privitera has received personal compensation for activities with UCB Pharmaceuticals and GSK as a consultant and speaker.Dr. Privitera has received research support from UCB Pharmaceuticals and Eisai. Dr. Loring received personal compensation from NeuroPace as a consultant." @default.
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• W2320137981 date "2012-04-22" @default.
• W2320137981 modified "2023-09-27" @default.
• W2320137981 title "Fetal Antiepileptic Drug and Folate Exposure: Cognitive Outcomes at Age 6 Years (IN5-2.003)" @default.
• W2320137981 doi "https://doi.org/10.1212/wnl.78.1_meetingabstracts.in5-2.003" @default.
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