Effects of periconceptional folate on cognition in children of women with epilepsy: NEAD study.

Neurology

From the Department of Neurology and Neurological Sciences (K.J.M.), Stanford University, CA; Department of Neurology (P.B.P.), Brigham and Women's Hospital, Harvard Medical School, Boston; The Emmes Corporation (R.C.M., C.A.B.), Rockville, MD; Walton Centre for Neurology & Neurosurgery (G.B.), University of Liverpool, Merseyside; Division of Evolution and Genomic Science (R.B.), School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, UK; Departments of Neurology and Pediatrics (D.W.L.), Emory University, Atlanta; and Pediatric Neuropsychology International (M.J.C.), Augusta, GA.

Published: February 2020

AI Article Synopsis

  • The study investigates how periconceptional folate affects neurodevelopment in children born to women with epilepsy treated with antiseizure medications (ASMs).
  • Data from the NEAD study, which involved 311 children and assessed various cognitive measures, was analyzed to explore these effects.
  • Results indicate that periconceptional folate is linked to improved Full Scale IQ and other cognitive indexes at ages 3 and 6, suggesting it could benefit cognitive development in this population.

Article Abstract

Objective: Emerging evidence suggests potential positive neuropsychological effects of periconceptional folate in both healthy children and children exposed in utero to antiseizure medications (ASMs). In this report, we test the hypothesis that periconceptional folate improves neurodevelopment in children of women with epilepsy by re-examining data from the Neurodevelopmental Effects of Antiepileptic Drugs (NEAD) study.

Methods: The NEAD study was an NIH-funded, prospective, observational, multicenter investigation of pregnancy outcomes in 311 children of 305 women with epilepsy treated with ASM monotherapy. Missing data points were imputed with Markov chain Monte Carlo methods. Multivariate analyses adjusted for multiple factors (e.g., maternal IQ, ASM type, standardized ASM dose, and gestational birth age) were performed to assess the effects of periconceptional folate on cognitive outcomes (i.e., Full Scale Intelligence Quotient [FSIQ], Verbal and Nonverbal indexes, and Expressive and Receptive Language indexes at 3 and 6 years of age, and executive function and memory function at 6 years of age).

Results: Periconceptional folate was associated with higher FSIQ at both 3 and 6 years of age. Significant effects for other measures included Nonverbal Index, Expressive Language Index, and Developmental Neuropsychological Assessment Executive Function at 6 years of age, and Verbal Index and Receptive Language Index at 3 years of age. Nonsignificant effects included Verbal Index, Receptive Index, Behavior Rating Inventory of Executive Function-Parent Questionnaire Executive Function, and General Memory Index at 6 years of age, and Nonverbal Index and Expressive Index at 3 years of age.

Conclusions: Use of periconceptional folate in pregnant women with epilepsy taking ASMs is associated with better cognitive development.

Clinicaltrialsgov Identifier: NCT00021866.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7176294PMC
http://dx.doi.org/10.1212/WNL.0000000000008757DOI Listing

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