Barton Sarah, Nadebaum Caroline, Anderson Vicki A, Vajda Frank, Reutens David C, Wood Amanda G
School of Psychology and Psychiatry, Monash University.
Clinical Sciences, Murdoch Children's Research Institute.
Neuropsychology. 2018 Oct;32(7):784-796. doi: 10.1037/neu0000465. Epub 2018 Jul 5.
Prenatal exposure to antiepileptic drugs (AEDs) and in particular valproate (VPA) has been shown to impair intellectual and language development in children, but the impact on memory functioning has not been thoroughly investigated. This study aimed to evaluate memory skills in school-age children who were exposed to AEDs prenatally.
The sample comprised of 105 children aged 6 to 8 years. Information on AED exposure, maternal epilepsy, pregnancy, and medical history was prospectively obtained. Children completed a neuropsychological assessment including measures of verbal and nonverbal memory.
Children exposed to VPA performed lower than expected on list learning, story recall, and figure recall tasks. Those exposed to VPA in a polytherapy regime achieved poorer verbal memory scores compared with other drug exposure groups. VPA dose was negatively correlated with both verbal and nonverbal memory measures. Language ability predicted performance on all verbal memory measures and VPA dose was an additional predictor of retroactive interference on the list learning task. Performance on figure recall was predicted by exposure to VPA in polytherapy. Children exposed to carbamazepine (CBZ) also showed a higher rate of impairment on nonverbal memory measures.
Both verbal and nonverbal memory skills are at risk in children exposed prenatally to VPA, particularly in those exposed to higher VPA doses. There may also be a selective vulnerability of the medial temporal lobe to VPA exposure. Our data highlight the possibility that nonverbal memory may also be affected in children exposed to CBZ. These findings have significant implications for the provision of cognitive and educational strategies to children exposed to AEDs in utero. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
产前暴露于抗癫痫药物（AEDs），尤其是丙戊酸盐（VPA），已被证明会损害儿童的智力和语言发育，但对记忆功能的影响尚未得到充分研究。本研究旨在评估产前暴露于AEDs的学龄儿童的记忆技能。
样本包括105名6至8岁的儿童。前瞻性地获取了有关AED暴露、母亲癫痫、妊娠和病史的信息。儿童完成了一项神经心理学评估，包括言语和非言语记忆测量。
暴露于VPA的儿童在列表学习、故事回忆和图形回忆任务上的表现低于预期。与其他药物暴露组相比，接受联合治疗方案的VPA暴露儿童的言语记忆得分较差。VPA剂量与言语和非言语记忆测量均呈负相关。语言能力预测了所有言语记忆测量的表现，VPA剂量是列表学习任务中逆向干扰的额外预测因素。图形回忆的表现由联合治疗中VPA的暴露情况预测。暴露于卡马西平（CBZ）的儿童在非言语记忆测量上也表现出较高的损伤率。
产前暴露于VPA的儿童，其言语和非言语记忆技能均面临风险，尤其是那些暴露于较高VPA剂量的儿童。内侧颞叶可能也对VPA暴露具有选择性易损性。我们的数据突出了暴露于CBZ的儿童的非言语记忆也可能受到影响的可能性。这些发现对为子宫内暴露于AEDs儿童提供认知和教育策略具有重要意义。（PsycINFO数据库记录（c）2018美国心理学会，保留所有权利）
