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The Australian Brain and Cognition and Antiepileptic Drugs Study: IQ in School-Aged Children Exposed to Sodium Valproate and Polytherapy

Published online by Cambridge University Press:  19 November 2010

Caroline Nadebaum ,
Vicki Anderson ,
Frank Vajda ,
David Reutens ,
Sarah Barton  and
Amanda Wood
Caroline Nadebaum
Affiliation:
School of Psychology and Psychiatry, Monash University, Melbourne, Australia Critical Care and Neurosciences, Murdoch Childrens Research Institute, Melbourne, Australia
Vicki Anderson
Affiliation:
Critical Care and Neurosciences, Murdoch Childrens Research Institute, Melbourne, Australia Department of Psychology, Royal Children’s Hospital, Melbourne, Australia Department of Psychology, University of Melbourne, Melbourne, Australia
Frank Vajda
Affiliation:
Department of Medicine, The Royal Melbourne Hospital, University of Melbourne, Melbourne, Australia
David Reutens
Affiliation:
Centre for Advanced Imaging, University of Queensland, Brisbane, Australia
Sarah Barton
Affiliation:
School of Psychology and Psychiatry, Monash University, Melbourne, Australia Critical Care and Neurosciences, Murdoch Childrens Research Institute, Melbourne, Australia
Amanda Wood*
Affiliation:
Critical Care and Neurosciences, Murdoch Childrens Research Institute, Melbourne, Australia Department of Medicine, Southern Clinical School, Monash University, Melbourne, Victoria, Australia School of Psychology, University of Birmingham, United Kingdom
*
Correspondence and reprint requests to: Amanda Wood, School of Psychology, The University of Birmingham, Edgbaston, B15 2TT, UK. E-mail: a.g.wood@bham.ac.uk
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Abstract

Prenatal exposure to sodium valproate (VPA) and polytherapy has been linked with increased risk of birth defects and cognitive impairment in young children. We evaluated the cognitive impact of prenatal exposure to VPA and polytherapy in school-aged children. Fifty-seven children exposed to VPA (n = 23), polytherapy with VPA (n = 15), or polytherapy without VPA (n = 19) were assessed using the Wechsler Intelligence Scale for Children—Fourth Edition. Information on maternal epilepsy, pregnancy, and medical history was obtained prospectively through the Australian Pregnancy Register for Women with Epilepsy and Allied Disorders. All groups had elevated frequencies of Extremely Low (<70) or Borderline (70–79) Full-Scale IQ (15.8–40.0%). Verbal Comprehension and Working Memory scores in all groups fell significantly below the standardized test mean, while Perceptual Reasoning and Processing Speed scores were relatively intact. Multivariate analysis of covariance analysis revealed significant main effects of VPA on Verbal Comprehension and Working Memory, and of polytherapy on Verbal Comprehension and Processing Speed. Our results suggest that VPA has a dose-dependent negative impact on verbal intellectual abilities, and may also affect working memory. The possibility that inclusion of VPA in many polytherapy regimens may underlie reduced mean scores of polytherapy-exposed children is discussed. (JINS, 2011, 17, 000–000)

Keywords

IntelligenceEpilepsyAnticonvulsantsPregnancyChild developmentPrenatal exposure delayed effects
Type
Research Articles
Information
Journal of the International Neuropsychological Society , Volume 17 , Issue 1 , January 2011 , pp. 133 - 142
Copyright
Copyright © The International Neuropsychological Society 2010

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