Evaluation of the effects of antiepileptic therapy on cognitive and psychical functioning and quality of life in school-age children with new-onset epilepsy

Uvod: Djeca sa epilepsijom se suočavaju sa promjenama u kognitivnom funkcionisanju, pojavom mentalnih problema i nezadovoljavajućim kvalitetom života. Kao potencijalni uzroci tih promjena razmatraju se neželjena dejstva antiepileptičkih ljekova (AEL). Glavni cilj: Ova studija ima za cilj da procjeni uticaj najčešće korišćenih AEL na kognitivni status, ponašanje, pojavu simptoma anksioznosti i depresije, kao i na kvalitet života djece sa novodijagnostikovanom epilepsijom tokom prvih šest mjeseci od započinjanja liječenja. Metod: Ovo je neintervencijska, prospektivna studija šestomjesečnog praćenja kognitivnog statusa, pojave internalizujućih i eksternalizujućih simptoma, kao i kvaliteta života kod djece sa novodijagnostikovanom epilepsijom. Djeci sa novodijagnostikovanom epilepsijom i njihovim roditeljima, neposredno nakon uvođenja AEL i šest mjeseci kasnije ponuđeni su odgovarajući upitnici (tj. RCADS, NCBRF, CHEQOL-25, KIDSCREEN-10, AEP i REVISK). Rezultati: Na samom početku liječenja REVISK testiranjem nađen je snižen VIQ, a nakon šest mjeseci došlo je do značajnog pada IQ, VIQ i naročito PIQ. Svi skorovi RCADS i NCBFR upitnika su nakon šest mjeseci bili značajano povišeni. Na razvoj simptoma depresije uticali su u značajnoj mjeri AEL. Skorovi CHEQOL-25 i KIDSCREEN-10 upitnika bili su značajno sniženi, u najvećoj mjeri pod uticajem neželjenih dejstava AEL i stanja kvaliteta života djeteta na početku liječenja. Zaključak: Neželjena dejstva AEL su značajno povezana sa ispoljavanjem depresivnih simptoma i snižavanjem kvaliteta života, ali ne utiču značajno na pad u kognitivnom statusu, pojavu anksioznosti, simptoma ADHD i poremećaja ponašanja, tokom prvih šest mjeseci od započinjanja liječenja, kod djece školskog uzrasta sa novodjagnostikovanom epilepsijom.Introduction: Children with epilepsy face changes in cognitive functioning, the appearance of symptoms of psychopathology and a decline in their quality of life. Factors related to the side effects of AED are considered to be potential causes of these changes. The primary goal of this study was to investigate the impact of the most commonly used antiepileptic drugs on cognitive status, behavior, anxiety and depression, as well as quality of life of children with newly-diagnosed epilepsy, during the first six months of treatment. Method: This is a non-interventional, prospective study involving six-month monitoring of cognitive status, internalizing and externalizing symptoms, as well as quality of life of children with newly-diagnosed epilepsy, and the impact of antiepileptic drugs on these domains. Children with new-onset epilepsy and their parents, immediately after the introduction of antiepileptic drugs as well as six months later, filled out appropriate questionnaires (RCADS, NCBRF, CHEQOL-25, KIDSCREEN-10, AEP, REVISK). Results: At the very beginning of REVISK treatment, a reduced VIQ was established, while after six months there was a significant decrease in IQ, VIQ and especially PIQ. All scores of the RCADS and NCBFR questionnaires were significantly elevated after six months. The development of depressive symptoms was significantly influenced by AED. The scores of the CHEQOL25 and KIDSCREEN10 questionnaires were significantly reduced, influenced by the adverse effects of AED and quality of life at the start of treatment. Conclusion: Side effects of AEDs, were significantly associated with depressive symptoms and reduced quality of life and did not significantly affect cognitive decline, anxiety, ADHD, and behavioral disorders during the first six months