Significant improvement in frontal lobe associated neuropsychological functions after withdrawal of Topiramate in epilepsy patients

Kockelmann, Edgar; Elger, Christian E.; Helmstaedter, Christoph

doi:10.1016/s0920-1211(03)00078-0

Cited by 107 publications

(64 citation statements)

References 16 publications

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“…La reducción de la ID podría potenciarse farmacológicamente, si bien es preciso tener en cuenta los efectos directos, dosis-dependientes, de los fármacos a utilizar (Vocci, 2008), teniendo en cuenta que algunos medicamentos, o algunas combinaciones de ellos, pueden mejorar o empeorar el funcionamiento córtico-frontal (p. ej., Gardner, Baldessarini y Waraich, 2005;Harvey y Keefe, 2001;Kockelmann, Elger y Helmstaedter, 2003). La incorporación de estrategias de evaluación y rehabilitación neurocognitiva (Fals-Stewart y Lam, 2010) podría colaborar a reducir la ID y aprovechar las capacidades atencionales vinculadas a la FI.…”

Section: Discussionunclassified

Caracterización neuropsicológica de la impulsividad funcional y disfuncional en adictos a sustancias: implicaciones clínicas

Pérez¹,

León

Mota

et al. 2012

Adicciones

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Impulsivity is a stable correlate throughout the course of drug addiction.However, it has always been studied as a negative condition, linked to psychopathology. Dickman (1990) proposed two subdimensions of impulsivity, dysfunctional (DI) and functional (FI). He defines the latter as the tendency for rapid, goal-oriented decision-making characterized by well calculated risks. Only a few studies have attempted to differentiate between these two subdimensions using classical neuropsychological tests. Fifty two drug addicts in treatment were tested using Dickman's Impulsivity Inventory and a battery of classical neuropsychological tests. FI shows moderate to high correlations with many classical neuropsychological test scores in relation to enhanced executive functioning, whereas DI reveals surprisingly weak and scarce correlations with indicators of impaired executive functioning. DI appears to be a trait related to some difficulties in classical neuropsychological tests, while FI emerges as a consistent and much stronger predictor of higher attention capacity, lower distractibility, better precision, fewer errors, and better maintenance of goal-oriented strategies. Thus, functional impulsivity is related to positive conditions and more efficient cognitive functioning.Implications for the treatment of drug addictions are suggested. La impulsividad es una de las variables más consistentemente vinculadas a las distintas fases del proceso adictivo. Sin embargo, casi siempre se ha estudiado como una condición negativa, vinculada a psicopatología. Dickman (1990) propuso dos tipos de impulsividad, una disfuncional (ID) y otra funcional (IF). A ésta última la definió como la tendencia a tomar decisiones rápidas, orientadas a metas, mediante un proceso de toma de decisiones con riesgo calculado. Pocos estudios han abordado la caracterización neuropsicológica de ambas variantes, relacionándolas con el rendimiento en pruebas clásicas. Una muestra de 52 sujetos adictos en tratamiento cumplimentó el Dickman Impulsivity Inventory y una batería de pruebas neuropsicológicas clásicas. Se observaron correlaciones de débiles a moderadas entre la IF e indicadores de éxito en las tareas neuropsicológicas, mientras que la ID mostró una relación difusa y débiles correlaciones con indicadores de mal rendimiento en todas las tareas. La ID se mostró como una disposición que dificulta la realización de las tareas de forma global, sin interferencia específica, en tanto que la IF se relacionó consistentemente con mayor precisión, menor número de errores y mejor mantenimiento de los planes, y ello a partir de una mejor gestión atencional y una mayor resistencia al ruido. Se sugieren las implicaciones de cara a los tratamientos de las adicciones.Palabras clave: Impulsividad funcional, impulsividad disfuncional, evaluación neuropsicológica, adicción, tratamiento, atención, funciones ejecutivas.

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Section: Discussionunclassified

Caracterización neuropsicológica de la impulsividad funcional y disfuncional en adictos a sustancias: implicaciones clínicas

Pérez¹,

León

Mota

et al. 2012

Adicciones

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“…Ultimately, assessing both pre-and post-operative performance in the same patients is necessary to definitively attribute such deficits to the impact of resective surgery. If such a study were to be performed, it would be helpful to evaluate potential intervening variables that might impact outcome on these category-specific measures (e.g., age of seizure onset, early risk factors for epilepsy, impact of primary pathologies leading to epilepsy), as these factors have proven to impact performance outcome using standard naming measures (Davies, Risse, & Gates, 2005;Saykin et al, 1995;Yucus & Tranel, in press) Although some of the newer antiepileptic drugs (AEDs) appear to negatively impact language functioning (e.g., topiramate, zonisamide: Kockelmann, Elger, & Helmstaedter, 2003;L. M. Ojemann et al, 2001), this finding has primarily involved verbal fluency rather than confrontation naming.…”

Section: Discussionmentioning

confidence: 99%

Category-specific naming and recognition deficits in temporal lobe epilepsy surgical patients

et al. 2008

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Objective-Based upon Damasio's "Convergence Zone" model of semantic memory, we predicted that epilepsy surgical patients with anterior temporal lobe (TL) seizure onset would exhibit a pattern of category-specific naming and recognition deficits not observed in patients with seizures arising elsewhere. Methods-We assessed epilepsy patients with unilateral seizure onset of anterior TL or other origin (n = 22), pre-or postoperatively, using a set of category-specific items and a conventional measure of visual naming (Boston Naming Test: BNT).Results-Category-specific naming deficits were exhibited by patients with dominant anterior TL seizure onset/resection for famous faces and animals, while category-specific recognition deficits for these same categories were exhibited by patients with nondominant anterior TL onset/resection. Patients with other seizure onset did not exhibit category-specific deficits. Naming and recognition deficits were frequently not detected by the BNT, which samples only a limited range of stimuli.Interpretation-Consistent with the "convergence zone" framework, results suggest that the nondominant anterior TL plays a major role in binding sensory information into conceptual percepts for certain stimuli, while dominant TL regions function to provide a link to verbal labels for these percepts. Although observed category-specific deficits were striking, they were often missed by the BNT, suggesting that they are more prevalent than recognized in both pre-and postsurgical epilepsy patients. Systematic investigation of these deficits could lead to more refined models of semantic memory, aid in the localization of seizures, and contribute to modifications in surgical technique and patient selection in epilepsy surgery to improve neurocognitive outcome. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. NIH Public Access Author ManuscriptNeuropsychologia. Author manuscript; available in PMC 2009 April 1. NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author ManuscriptKeywords semantic memory; temporal lobe epilepsy; category-specific deficits; epilepsy surgery; naming deficits While several models of semantic memory exist, most agree that the temporal lobes play an important role in supporting this cognitive construct (Caramazza & Shelton, 1998;H. Damasio, Tranel, Grabowski, Adolphs, & Damasio, 2004;Gainotti, 2006). Research suggesting a role for the temporal lobes in semantic memory includes a variety of studies demonstrating deficits in this area in patients with TL impairment (Bayles, Tomoeda, & Trosset, 1990;Chan et al., 1993;Garrard, Lam...

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“…47 After withdrawal verbal fluency, attention and verbal and spatial span was improved. 48 Patients suffering from temporal lobe epilepsy and having past psychiatric problems are more vulnerable to cognitive impairment with topiramate. 8,49 Usual adult daily dose of topiramate is 200-400 mg and target range of plasma concentration is 2-25 µg/ml.…”

Section: Topiramatementioning

confidence: 99%

Impact of anti-epileptic drugs on cognition: a review

Rai

Shah

Yadav

et al. 2016

Int J Basic Clin Pharmacol

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Significant improvement in frontal lobe associated neuropsychological functions after withdrawal of Topiramate in epilepsy patients

Cited by 107 publications

References 16 publications

Caracterización neuropsicológica de la impulsividad funcional y disfuncional en adictos a sustancias: implicaciones clínicas

Caracterización neuropsicológica de la impulsividad funcional y disfuncional en adictos a sustancias: implicaciones clínicas

Category-specific naming and recognition deficits in temporal lobe epilepsy surgical patients

Impact of anti-epileptic drugs on cognition: a review

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