INS NYC 2024 Program

Poster	Poster Session 09 Program Schedule 02/16/2024 03:30 pm - 04:45 pm Room: Shubert Complex (Posters 1-60) Poster Session 09: Epilepsy \| Oncology \| MS \| Infectious Disease Final Abstract #56 Antiseizure Medication Effects on the Boston Naming Test Response Time Hyun Jin Kang, University of Washington, Seattle, United States Michelle Kim, University of Washington, Seattle, United States Karen Torres, University of Washington, Seattle, United States Adam Dickey, Emory University, Atlanta, United States Kelsey Hewitt, Emory University, Atlanta, United States Aastha Bansal, Emory University, Atlanta, United States Scott Millis, Wayne State University, Detroit, United States Daniel Drane, Emory University, Atlanta, United States Category: Epilepsy/Seizures Keyword 1: epilepsy / seizure disorders Keyword 2: naming Objective: As mild declines in response time on confrontation visual naming tasks have been associated with poor functional outcome after tumor surgery, we have become interested in assessing this metric in the setting of epilepsy surgery. However, given that antiseizure medications (ASMs) have been shown to have an effect on response speed and executive function, we felt that it would be useful to first better establish the effects of ASMs on the most commonly used visual naming measure in a presurgical population. Participants and Methods: Response times on the Boston Naming Test (BNT) were analyzed for 56 subjects with temporal lobe epilepsy (TLE) undergoing surgical evaluation at either the University of Washington or Emory University and a set of healthy control subjects (n = 40). Mean response time was calculated based on all spontaneously named items for each subject. We stratified the TLE patients by number of medications: 1) TLE subjects on ≤ 2 ASMs (n = 39) or 2) TLE subjects on ≥3 ASMs (n = 17). We also explored whether there were greater effects of slowing for the subgroup of TLE patients treated with decarboxylase inhibitors (i.e., topiramate or zonisamide), given the known adverse effects that these ASMs can have on verbal processing. The Wilcoxon rank-sum test was used to compare the medians of the groups’ BNT response times. Results: Subjects with TLE had a significantly slower median BNT response time of 2.10 seconds compared to 1.31 seconds of healthy controls (p < .001). Within the epilepsy cohort, the group taking ≤2 ASMs had a median BNT time of 1.91 seconds, which was non-significantly lower than the group taking ≥3 ASMs who had a median BNT time of 2.20 seconds (p = .18). Patients treated with the decarboxylase inhibitors (n = 11) did not perform worse than those who were not, with both groups exhibiting the identical median BNT time of 2.10 seconds (p = .55). Conclusions: Patients with TLE demonstrated slower response time on confrontation visual naming compared to healthy controls, suggesting a potential neuropathological disturbance of language processing among patients with TLE. While TLE patients tended to perform slower with increasing numbers of ASMs, this did not reach statistical significance in our modest sample size. Moreover, those on the decarboxylase inhibitors considered to have adverse verbal processing effects did not perform significantly slower compared to those who were not on these medications. Larger sample sizes with a wider range of number of ASMs may provide greater insight into the slowed verbal response in TLE. Future studies examining other factors potentially associated with response time, such as demographics (i.e., age, gender, education), disease-related factors (i.e., duration of epilepsy, seizure severity), and psychiatric comorbidities (i.e., anxiety, depression), should be considered. In addition, given our current findings, future research might consider the possibility that the adverse impact of decarboxylase inhibitors could be driven more by executive dysfunction than response time, particularly as prior research has utilized language tasks that may be mediated by executive function rather than naming in assessing language processing.

Poster

02/16/2024
03:30 pm - 04:45 pm
Room: Shubert Complex (Posters 1-60)

Poster Session 09: Epilepsy | Oncology | MS | Infectious Disease

Final Abstract #56

Antiseizure Medication Effects on the Boston Naming Test Response Time

Hyun Jin Kang, University of Washington, Seattle, United States
Michelle Kim, University of Washington, Seattle, United States
Karen Torres, University of Washington, Seattle, United States
Adam Dickey, Emory University, Atlanta, United States
Kelsey Hewitt, Emory University, Atlanta, United States
Aastha Bansal, Emory University, Atlanta, United States
Scott Millis, Wayne State University, Detroit, United States
Daniel Drane, Emory University, Atlanta, United States

Category: Epilepsy/Seizures

Keyword 1: epilepsy / seizure disorders
Keyword 2: naming

Objective:

As mild declines in response time on confrontation visual naming tasks have been associated with poor functional outcome after tumor surgery, we have become interested in assessing this metric in the setting of epilepsy surgery. However, given that antiseizure medications (ASMs) have been shown to have an effect on response speed and executive function, we felt that it would be useful to first better establish the effects of ASMs on the most commonly used visual naming measure in a presurgical population.

Participants and Methods:

Response times on the Boston Naming Test (BNT) were analyzed for 56 subjects with temporal lobe epilepsy (TLE) undergoing surgical evaluation at either the University of Washington or Emory University and a set of healthy control subjects (n = 40). Mean response time was calculated based on all spontaneously named items for each subject. We stratified the TLE patients by number of medications: 1) TLE subjects on ≤ 2 ASMs (n = 39) or 2) TLE subjects on ≥3 ASMs (n = 17). We also explored whether there were greater effects of slowing for the subgroup of TLE patients treated with decarboxylase inhibitors (i.e., topiramate or zonisamide), given the known adverse effects that these ASMs can have on verbal processing. The Wilcoxon rank-sum test was used to compare the medians of the groups’ BNT response times.

Results:

Subjects with TLE had a significantly slower median BNT response time of 2.10 seconds compared to 1.31 seconds of healthy controls (p < .001). Within the epilepsy cohort, the group taking ≤2 ASMs had a median BNT time of 1.91 seconds, which was non-significantly lower than the group taking ≥3 ASMs who had a median BNT time of 2.20 seconds (p = .18). Patients treated with the decarboxylase inhibitors (n = 11) did not perform worse than those who were not, with both groups exhibiting the identical median BNT time of 2.10 seconds (p = .55).

Conclusions:

Patients with TLE demonstrated slower response time on confrontation visual naming compared to healthy controls, suggesting a potential neuropathological disturbance of language processing among patients with TLE. While TLE patients tended to perform slower with increasing numbers of ASMs, this did not reach statistical significance in our modest sample size. Moreover, those on the decarboxylase inhibitors considered to have adverse verbal processing effects did not perform significantly slower compared to those who were not on these medications. Larger sample sizes with a wider range of number of ASMs may provide greater insight into the slowed verbal response in TLE. Future studies examining other factors potentially associated with response time, such as demographics (i.e., age, gender, education), disease-related factors (i.e., duration of epilepsy, seizure severity), and psychiatric comorbidities (i.e., anxiety, depression), should be considered. In addition, given our current findings, future research might consider the possibility that the adverse impact of decarboxylase inhibitors could be driven more by executive dysfunction than response time, particularly as prior research has utilized language tasks that may be mediated by executive function rather than naming in assessing language processing.