Distinct cognitive neurophysiologic profiles for lamotrigine and topiramate

Michael E. Smith, Alan Gevins, Linda K. McEvoy, Kimford J. Meador, Patricia G. Ray, Frank Gilliam

Research output: Contribution to journalArticle

55 Citations (Scopus)

Abstract

Purpose: To contrast the effects of lamotrigine (LTG) and topiramate (TPM) on cognitive task-related and resting-state EEG and evoked potential (EP) measures. Methods: We used a double-blind, randomized, crossover design. Healthy adults (N = 29) had two 8-week periods of dose escalation, 4 weeks of drug maintenance (300 mg daily), and 4 weeks of washout. EEG was recorded during working memory (WM) tasks and resting conditions at baseline, at the end of each maintenance phase, and after final washout. Results: LTG did not affect overt performance on the tasks, although it reduced EEG power in both resting and WM task conditions, most prominently in the 6- to 12-Hz frequency range, and attenuated P300 evoked-potential amplitude equally in both WM task loads. TPM slowed responses and increased errors. It also increased EEG power below 6 Hz in all conditions, and reduced the amplitude of a slow wave observed in a difficult version of the WM task. Conclusions: The drugs produced both task-independent and task-related alterations in neurophysiologic measures. The EEG and EP changes produced by TPM are consistent with an impairment of WM, as evidenced by overt performance deficits on the behavioral tasks. By contrast, the reduction in synchronous cortical activity produced by LTG was not accompanied by cognitive impairment. It is unknown whether such effects would also be observed at lower doses, such as those that often are used in monotherapy for newly diagnosed patients.

Original languageEnglish (US)
Pages (from-to)695-703
Number of pages9
JournalEpilepsia
Volume47
Issue number4
DOIs
StatePublished - Apr 1 2006

Fingerprint

Short-Term Memory
Electroencephalography
Evoked Potentials
Maintenance
Task Performance and Analysis
Pharmaceutical Preparations
Cross-Over Studies
topiramate
lamotrigine
Power (Psychology)

Keywords

  • Antiepileptic drugs
  • Cognition
  • EEG
  • Epilepsy
  • Evoked potentials
  • Lamotrigine
  • Neurophysiology
  • Topiramate
  • Working memory

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

Cite this

Smith, M. E., Gevins, A., McEvoy, L. K., Meador, K. J., Ray, P. G., & Gilliam, F. (2006). Distinct cognitive neurophysiologic profiles for lamotrigine and topiramate. Epilepsia, 47(4), 695-703. https://doi.org/10.1111/j.1528-1167.2006.00508.x

Distinct cognitive neurophysiologic profiles for lamotrigine and topiramate. / Smith, Michael E.; Gevins, Alan; McEvoy, Linda K.; Meador, Kimford J.; Ray, Patricia G.; Gilliam, Frank.

In: Epilepsia, Vol. 47, No. 4, 01.04.2006, p. 695-703.

Research output: Contribution to journalArticle

Smith, ME, Gevins, A, McEvoy, LK, Meador, KJ, Ray, PG & Gilliam, F 2006, 'Distinct cognitive neurophysiologic profiles for lamotrigine and topiramate', Epilepsia, vol. 47, no. 4, pp. 695-703. https://doi.org/10.1111/j.1528-1167.2006.00508.x
Smith ME, Gevins A, McEvoy LK, Meador KJ, Ray PG, Gilliam F. Distinct cognitive neurophysiologic profiles for lamotrigine and topiramate. Epilepsia. 2006 Apr 1;47(4):695-703. https://doi.org/10.1111/j.1528-1167.2006.00508.x
Smith, Michael E. ; Gevins, Alan ; McEvoy, Linda K. ; Meador, Kimford J. ; Ray, Patricia G. ; Gilliam, Frank. / Distinct cognitive neurophysiologic profiles for lamotrigine and topiramate. In: Epilepsia. 2006 ; Vol. 47, No. 4. pp. 695-703.
@article{8c07db7d672a4fe380730ff56185945a,
title = "Distinct cognitive neurophysiologic profiles for lamotrigine and topiramate",
abstract = "Purpose: To contrast the effects of lamotrigine (LTG) and topiramate (TPM) on cognitive task-related and resting-state EEG and evoked potential (EP) measures. Methods: We used a double-blind, randomized, crossover design. Healthy adults (N = 29) had two 8-week periods of dose escalation, 4 weeks of drug maintenance (300 mg daily), and 4 weeks of washout. EEG was recorded during working memory (WM) tasks and resting conditions at baseline, at the end of each maintenance phase, and after final washout. Results: LTG did not affect overt performance on the tasks, although it reduced EEG power in both resting and WM task conditions, most prominently in the 6- to 12-Hz frequency range, and attenuated P300 evoked-potential amplitude equally in both WM task loads. TPM slowed responses and increased errors. It also increased EEG power below 6 Hz in all conditions, and reduced the amplitude of a slow wave observed in a difficult version of the WM task. Conclusions: The drugs produced both task-independent and task-related alterations in neurophysiologic measures. The EEG and EP changes produced by TPM are consistent with an impairment of WM, as evidenced by overt performance deficits on the behavioral tasks. By contrast, the reduction in synchronous cortical activity produced by LTG was not accompanied by cognitive impairment. It is unknown whether such effects would also be observed at lower doses, such as those that often are used in monotherapy for newly diagnosed patients.",
keywords = "Antiepileptic drugs, Cognition, EEG, Epilepsy, Evoked potentials, Lamotrigine, Neurophysiology, Topiramate, Working memory",
author = "Smith, {Michael E.} and Alan Gevins and McEvoy, {Linda K.} and Meador, {Kimford J.} and Ray, {Patricia G.} and Frank Gilliam",
year = "2006",
month = "4",
day = "1",
doi = "10.1111/j.1528-1167.2006.00508.x",
language = "English (US)",
volume = "47",
pages = "695--703",
journal = "Epilepsia",
issn = "0013-9580",
publisher = "Wiley-Blackwell",
number = "4",

}

TY - JOUR

T1 - Distinct cognitive neurophysiologic profiles for lamotrigine and topiramate

AU - Smith, Michael E.

AU - Gevins, Alan

AU - McEvoy, Linda K.

AU - Meador, Kimford J.

AU - Ray, Patricia G.

AU - Gilliam, Frank

PY - 2006/4/1

Y1 - 2006/4/1

N2 - Purpose: To contrast the effects of lamotrigine (LTG) and topiramate (TPM) on cognitive task-related and resting-state EEG and evoked potential (EP) measures. Methods: We used a double-blind, randomized, crossover design. Healthy adults (N = 29) had two 8-week periods of dose escalation, 4 weeks of drug maintenance (300 mg daily), and 4 weeks of washout. EEG was recorded during working memory (WM) tasks and resting conditions at baseline, at the end of each maintenance phase, and after final washout. Results: LTG did not affect overt performance on the tasks, although it reduced EEG power in both resting and WM task conditions, most prominently in the 6- to 12-Hz frequency range, and attenuated P300 evoked-potential amplitude equally in both WM task loads. TPM slowed responses and increased errors. It also increased EEG power below 6 Hz in all conditions, and reduced the amplitude of a slow wave observed in a difficult version of the WM task. Conclusions: The drugs produced both task-independent and task-related alterations in neurophysiologic measures. The EEG and EP changes produced by TPM are consistent with an impairment of WM, as evidenced by overt performance deficits on the behavioral tasks. By contrast, the reduction in synchronous cortical activity produced by LTG was not accompanied by cognitive impairment. It is unknown whether such effects would also be observed at lower doses, such as those that often are used in monotherapy for newly diagnosed patients.

AB - Purpose: To contrast the effects of lamotrigine (LTG) and topiramate (TPM) on cognitive task-related and resting-state EEG and evoked potential (EP) measures. Methods: We used a double-blind, randomized, crossover design. Healthy adults (N = 29) had two 8-week periods of dose escalation, 4 weeks of drug maintenance (300 mg daily), and 4 weeks of washout. EEG was recorded during working memory (WM) tasks and resting conditions at baseline, at the end of each maintenance phase, and after final washout. Results: LTG did not affect overt performance on the tasks, although it reduced EEG power in both resting and WM task conditions, most prominently in the 6- to 12-Hz frequency range, and attenuated P300 evoked-potential amplitude equally in both WM task loads. TPM slowed responses and increased errors. It also increased EEG power below 6 Hz in all conditions, and reduced the amplitude of a slow wave observed in a difficult version of the WM task. Conclusions: The drugs produced both task-independent and task-related alterations in neurophysiologic measures. The EEG and EP changes produced by TPM are consistent with an impairment of WM, as evidenced by overt performance deficits on the behavioral tasks. By contrast, the reduction in synchronous cortical activity produced by LTG was not accompanied by cognitive impairment. It is unknown whether such effects would also be observed at lower doses, such as those that often are used in monotherapy for newly diagnosed patients.

KW - Antiepileptic drugs

KW - Cognition

KW - EEG

KW - Epilepsy

KW - Evoked potentials

KW - Lamotrigine

KW - Neurophysiology

KW - Topiramate

KW - Working memory

UR - http://www.scopus.com/inward/record.url?scp=33645530397&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33645530397&partnerID=8YFLogxK

U2 - 10.1111/j.1528-1167.2006.00508.x

DO - 10.1111/j.1528-1167.2006.00508.x

M3 - Article

C2 - 16650135

AN - SCOPUS:33645530397

VL - 47

SP - 695

EP - 703

JO - Epilepsia

JF - Epilepsia

SN - 0013-9580

IS - 4

ER -