Investigating the Effect of Cognitive Rehabilitation on Cognitive Impairment Associated With Antiseizure Medications in Patients With Epilepsy

Abstract

Objective: Most existing studies on cognitive rehabilitation in epilepsy focus on patients undergoing epilepsy surgery or classify interventions based on epilepsy type. This study aimed to determine whether antiseizure medications (ASMs) cause cognitive dysfunction in epilepsy patients by using neuropsychological assessments and auditory event-related potentials (ERPs), and whether cognitive rehabilitation can reduce this potential impact. Materials and Methods: The study included patients scheduled to begin ASM monotherapy. All participants first underwent a face-to-face Montreal Cognitive Assessment (MoCA). Auditory ERPs including P300 and N200 latencies, and N2 to P3 peak-to-peak amplitudes were recorded in the electrophysiology laboratory. Patients were randomly divided into two groups: Group A (no cognitive rehabilitation) and Group B (received cognitive rehabilitation). After two months, both MoCA and auditory ERP measurements were repeated, and the results were statistically analyzed. Results: In Group A, patients using carbamazepine (CBZ), zonisamide (ZNS), or valproic acid (VPA) showed a statistically significant decline in MoCA scores and auditory ERP results (P < .05), suggesting a protective role of rehabilitation. For topiramate (TPM), cognitive decline was weakly significant even with rehabilitation (P = .031)