Patients with epilepsy often suffer from cognitive impairments. Seizure control can improve cognitive status; yet the anti-epileptic drugs (AEDs) often used for this purpose can themselves affect mental function. Thus, defining an effective treatment for an individual patient often requires balancing seizure control with potential medication side effects. While efficacy for seizure control is relatively easy for the clinician to gauge, currently there is no efficient objective measure of brain function used to assess changes in cognitive status during treatment. We propose to develop a specialized system, the Ant epileptic Neurotoxicity Test (ANT), to address this need. Our prior research suggests that sensitive indices of attention and memory can be derived from multivariate combinations of EEG, ERP and behavioral performance measures. During Phase I we demonstrated that such methods are sensitive to both acute dosing with older generation medications, and to the cognitive side effects of chronic dosing with newer AEDs. Progress was also made on the design and implementation of an automated clinical testing system that the ANT would be based on, and on defining modifications to signal processing algorithms to accommodate abnormal EEGs. In Phase II our methods will be extended and a prototype ANT will be implemented and validated in collaborative studies with epilepsy specialists. A resulting first generation ANT will enable research on the neurocognitive changes associated with epilepsy treatments, providing an efficient, standardized means to measure cognitive brain function across different laboratories and clinics. With refinement, the system could improve patient care, for example by helping a physician to select the best drug and dose level for an individual patient. There is a significant market demand for such a device in the context of epileptology, and related products could find widespread use as assessment tools in many areas of neurology and psychiatry.
| Gevins, Alan; McEvoy, Linda K; Smith, Michael E et al. (2012) Long-term and within-day variability of working memory performance and EEG in individuals. Clin Neurophysiol 123:1291-9 |
