The Australian brain and cognition and antiepileptic drugs study: IQ in school-aged children exposed to sodium valproate and polytherapy

Caroline Nadebaum, Vicki Anderson, Frank Vajda, David Reutens, Sarah Barton, Amanda Wood

Research output: Contribution to journalArticle

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)
Original languageEnglish
Pages (from-to)133-142
Number of pages10
JournalJournal of the International Neuropsychological Society
Volume17
Issue number1
Early online date19 Nov 2010
DOIs
Publication statusPublished - Jan 2011

Fingerprint

Valproic Acid
Anticonvulsants
Cognition
Brain
Short-Term Memory
Epilepsy
Wechsler Scales
Reproductive History
Aptitude
Intelligence
Multivariate Analysis
Mothers
Pregnancy

Keywords

  • prenatal exposure delayed effects
  • pregnancy
  • anticonvulsants
  • child development
  • epilepsy
  • intelligence

Cite this

Nadebaum, C., Anderson, V., Vajda, F., Reutens, D., Barton, S., & Wood, A. (2011). The Australian brain and cognition and antiepileptic drugs study: IQ in school-aged children exposed to sodium valproate and polytherapy. Journal of the International Neuropsychological Society, 17(1), 133-142. https://doi.org/10.1017/S1355617710001359
Nadebaum, Caroline ; Anderson, Vicki ; Vajda, Frank ; Reutens, David ; Barton, Sarah ; Wood, Amanda. / The Australian brain and cognition and antiepileptic drugs study : IQ in school-aged children exposed to sodium valproate and polytherapy. In: Journal of the International Neuropsychological Society. 2011 ; Vol. 17, No. 1. pp. 133-142.
@article{47ffa94817734d8db8746e9a56ae4058,
title = "The Australian brain and cognition and antiepileptic drugs study: IQ in school-aged children exposed to sodium valproate and polytherapy",
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 = "prenatal exposure delayed effects, pregnancy, anticonvulsants, child development, epilepsy, intelligence",
author = "Caroline Nadebaum and Vicki Anderson and Frank Vajda and David Reutens and Sarah Barton and Amanda Wood",
year = "2011",
month = "1",
doi = "10.1017/S1355617710001359",
language = "English",
volume = "17",
pages = "133--142",
number = "1",

}

Nadebaum, C, Anderson, V, Vajda, F, Reutens, D, Barton, S & Wood, A 2011, 'The Australian brain and cognition and antiepileptic drugs study: IQ in school-aged children exposed to sodium valproate and polytherapy', Journal of the International Neuropsychological Society, vol. 17, no. 1, pp. 133-142. https://doi.org/10.1017/S1355617710001359

The Australian brain and cognition and antiepileptic drugs study : IQ in school-aged children exposed to sodium valproate and polytherapy. / Nadebaum, Caroline; Anderson, Vicki; Vajda, Frank; Reutens, David; Barton, Sarah; Wood, Amanda.

In: Journal of the International Neuropsychological Society, Vol. 17, No. 1, 01.2011, p. 133-142.

Research output: Contribution to journalArticle

TY - JOUR

T1 - The Australian brain and cognition and antiepileptic drugs study

T2 - IQ in school-aged children exposed to sodium valproate and polytherapy

AU - Nadebaum, Caroline

AU - Anderson, Vicki

AU - Vajda, Frank

AU - Reutens, David

AU - Barton, Sarah

AU - Wood, Amanda

PY - 2011/1

Y1 - 2011/1

N2 - 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)

AB - 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)

KW - prenatal exposure delayed effects

KW - pregnancy

KW - anticonvulsants

KW - child development

KW - epilepsy

KW - intelligence

UR - https://www.cambridge.org/core/journals/journal-of-the-international-neuropsychological-society/article/australian-brain-and-cognition-and-antiepileptic-drugs-study-iq-in-schoolaged-children-exposed-to-sodium-valproate-and-polytherapy/95AA04E9B556A8E8FE2FB9D069D60AA2

U2 - 10.1017/S1355617710001359

DO - 10.1017/S1355617710001359

M3 - Article

VL - 17

SP - 133

EP - 142

IS - 1

ER -

Nadebaum C, Anderson V, Vajda F, Reutens D, Barton S, Wood A. The Australian brain and cognition and antiepileptic drugs study: IQ in school-aged children exposed to sodium valproate and polytherapy. Journal of the International Neuropsychological Society. 2011 Jan;17(1):133-142. https://doi.org/10.1017/S1355617710001359