Cognitive Rehabilitation in Epilepsy Patients: New Insights on Cognitive Dysfunction

Strategic Insights -

Researchers at Gulhane Training and Research Hospital in Ankara, Turkey, have conducted a study to determine whether antiseizure medications (ASMs) cause cognitive dysfunction in epilepsy patients. The study involved patients scheduled to begin ASM monotherapy and aimed to assess the impact of cognitive rehabilitation on cognitive impairment associated with ASMs. The results of the study, published in Clinical EEG and Neuroscience, have provided new insights into the effect of cognitive rehabilitation on cognitive decline in epilepsy patients taking ASMs.

Key Takeaways:

  • The study included 100 patients scheduled to begin ASM monotherapy, who were randomly divided into two groups: Group A (no cognitive rehabilitation) and Group B (received cognitive rehabilitation).
  • Patients using carbamazepine (CBZ), zonisamide (ZNS), or valproic acid (VPA) showed a statistically significant decline in MoCA scores and auditory ERP results after two months.
  • For topiramate (TPM), cognitive decline was weakly significant even with rehabilitation.
  • The study's findings suggest that cognitive rehabilitation may not be effective in reducing cognitive decline associated with ASMs, especially for TPM.
  • The Montreal Cognitive Assessment (MoCA) and auditory event-related potentials (ERPs) were used to assess cognitive function and auditory processing, respectively.

Statistics:

  • 100 patients were included in the study, with 50 patients in each group (Group A and Group B).
  • Patients using CBZ, ZNS, or VPA showed a statistically significant decline in MoCA scores, with a mean decrease of 5.2 points (p < 0.01).
  • Patients using TPM showed a weakly significant decline in MoCA scores, with a mean decrease of 2.1 points (p = 0.06).
  • The N200 latency was significantly prolonged in Group A patients using CBZ (p < 0.01), while the N2 to P3 peak-to-peak amplitude was significantly reduced in Group A patients using VPA (p < 0.05).

Sources:

  • "Investigating the Effect of Cognitive Rehabilitation on Cognitive Impairment Associated With Antiseizure Medications in Patients With Epilepsy." Clinical EEG and Neuroscience, 2025:15500594251376071.
  • NewsRx. Reports on Epilepsy from Gulhane Training and Research Hospital Provide New Insights (Investigating the Effect of Cognitive Rehabilitation on Cognitive Impairment Associated With Antiseizure Medications in Patients With Epilepsy). Health & Medicine Week. October 24, 2025; p 4877.