Impact of anti-epileptic drugs on cognition: a review

A Prospective Study of Longitudinal Risks of Cognitive Deficit for People Undergoing Glioblastoma Surgery Using a Tablet Computer Cognition Testing Battery: Towards Personalized Understanding of Risks to Cognitive Function

“…A final strength of the current study is the level of annotative detail included in the co-variate modelling, spanning from steroid and antiepileptic medication usage to radiological tumour volume and molecular diagnostic sub-typing based on IDH and MGMT promoter status. Whilst such confounding variables as years of education and usage of steroid and anti-epileptic medications have been associated with cognitive deficits and overall outcomes [ 32 , 33 ], in the current study the effect size of such interactions is much smaller than the time in relation to surgery and hence is insufficiently powered to detect them. Towards the end of the study, patients were still undergoing routine treatment for glioblastoma during the start of the COVID-19 pandemic.…”

“…Clinical co-variates of potential confounding effect were included in the analysis: Demographic data: age [ 28 ] and sex, years of education [ 29 ]; Anxiety [ 30 ] and depression [ 31 ]; Medications: dexamethasone steroid [ 32 ] and anti-epileptic medications [ 33 ] given peri-operatively as per electronic record charts. The highest recorded dose of each was used as a surrogate measure for each to account of the effect size of this variable; Molecular marker information: IDH and MGMT status [ 34 , 35 ]; Surgical adjuncts: the use of 5-Aminolevulinic acid [ 10 ], intraoperative neurophysiology or awake mapping [ 36 ]; Surgical outcome: complete resection of enhancing tumour or subtotal with residual [ 37 ]; Timing of assessment: all dates of surgery and subsequent assessments were recorded in number of days from the first assessment to determine whether there was a recovery time effect [ 38 ]; Tumour Volume: calculated using the measurements from the reports by Consultant Neuroradiologists for consistency (perpendicular dimensions in the maximal axial plane slice of MRI) [ 35 , 39 ].…”

“…Medications: dexamethasone steroid [ 32 ] and anti-epileptic medications [ 33 ] given peri-operatively as per electronic record charts. The highest recorded dose of each was used as a surrogate measure for each to account of the effect size of this variable;…”