The Portland Neurotoxicity Scale (PNS) is a brief patient-based survey of neurotoxicity complaints commonly encountered with the use of antiepileptic drugs (AEDs). The authors present data on the validity of this scale, particularly when used in longitudinal studies. Participants included 55 healthy controls, 23 epilepsy patient controls, and 86 healthy volunteers who took various AEDs or placebos for 12 weeks as part of randomized, double-blind studies of AED effects on cognitive abilities. Test-retest reliability in the control groups averaged .80 (total score). Test-retest changes in the PNS were sensitive to AED usage in general (p < .001) and to each of the five AEDs tested but not to placebo. Test-retest changes in the PNS were strongly correlated with several scales of the Profile of Mood States but only weakly correlated with objective cognitive test measures. The PNS has satisfactory psychometric properties and is sensitive to AED usage in test-retest studies.
Aldenkamp, A., Baker, G., Pieters, M., Schoemaker, H., Cohen, A., & Schwabe, S. (1995). The Neurotoxicity Scale: The validity of a patient based scale assessing neurotoxicity. Epilepsy Research, 20, 229-239.
2.
Aldenkamp, A., Van Meel, H., Baker, G., Brooks, J., & Hendriks, M. (2002). The A-B Neuropsychological Assessment Schedule (ABNAS): The relationship between patient perceived drug-related cognitive impairment and results of neuropsychological tests. Seizure, 11, 231-237.
3.
Baldy-Moulinier, M., Belaidi, M., Rondouin, G., & Touchon, J. (1991). Daytime alertness disturbance in epileptic patients with complex partial seizures. Epilepsia, 32(Suppl. 1), 117.
4.
Binder, L., Storzbach, D., Anger, W., Campbell, K., & Rohlman, D. (1999). Subjective cognitive complaints, affective distress, and objective cognitive performance in Persian Gulf War veterans. Archives of Clinical Neuropsychology, 14, 531-536.
5.
Biton, V., Montouris, G., Ritter, F., Riviello, J., Reife, R., Lim, P., et al. (1999). A randomized, placebo-controlled study of topiramate in primary generalized tonic-clonic seizures. Neurology, 52, 1330-1337.
6.
Brooks, J., Baker, G., & Aldenkamp, A. (2001). The A-B Neuropsychological Assessment Schedule(ABNAS): Further refinement of a patient based scale of patient perceived cognitive functioning. Epilepsy Research, 43, 227-237.
7.
Bushke, H., & Fuld, P. (1974). Evaluating storage, retention and retrieval in disordered memory and learning. Neurology, 24, 1019-1025.
8.
Cereghino, J., Biton, V., Abou-kahlil, B., Dreifuss, F., Gauer, L. J., & Leppik, I. (2000). Levetiracetam for partial seizures: Results of a double-blind, randomized clinical trial. Neurology, 55, 230-242.
9.
Chadwick, D., Anhut, H., Greiner, M., Alexander, J., Murray, G., Garofalo, E., et al. (1998). A double-blind trial of gabapentin monotherapy for newly diagnosed partial seizures. Neurology, 51, 1282-1288.
10.
Collaborative Group for the Study of Epilepsy. (1986). Adverse reaction to antiepileptic drugs: A multicenter survey of clinical practice. Epilepsia, 27, 323-330.
11.
Devinsky, O., Vickrey, B., Cramer, J., Perrine, K., Herrmann, B., Meador, K., et al. (1995). Development of the quality of life in epilepsy inventory. Epilepsia, 11, 1089-1104.
12.
Dodrill, C. (1975). Diphenylhydantoin serum levels, toxicity and neuropsychological performance in patients with epilepsy. Epilepsia, 16, 593-600.
13.
Dodrill, C. (1978). A neuropsychological test battery for epilepsy. Epilepsia, 19, 611-623.
14.
Dodrill, C. (1991). When is computer assisted testing appropriate? In W. Dodson, M. Kinsbourne, & B. Hiltbrunner (Eds.), The assessment of cognitive function in epilepsy (pp. 23-34). New York: Demos.
15.
Dodrill, C., Arnett, J., Somerville, K., & Sussman, N. (1995). Effects of differing dosages of vigabatrin on cognitive abilities and quality of life in epilepsy. Epilepsia, 36, 164-173.
16.
Duncan, J., Shorvon, S., & Trimble, M. (1990). Effects of removal of phenytoin, carbamazepine, and valproate on cognitive function. Epilepsia, 31, 584-591.
17.
Elixhauser, A., Leidy, N. K., Meador, K., Means, E., & Willan, M. K. (1999). The relationship between memory performance, perceived cognitive function, and mood in patients with epilepsy. Epilepsy Research, 37, 13-24.
18.
Gilliam, F. (2002). Optimizing health outcomes in active epilepsy. Neurology, 58, S9-S20.
19.
Larrabee, G., Trahan, D., & Levin, H. (1986). Normative data for a six-trial version of the Verbal Selective Reminding Test. Clinical Neuropsychology, 14, 110-118.
20.
Mattson, R. H. (1989). General principles: Selection of antiepileptic drug therapy. In R. H. Levy, F. E. Dreifuss, R. H. Mattson,& B. S. Meldrum (Eds.), Antiepileptic drugs (3rd ed., pp.103-115). New York:Raven.
21.
Mattson, R. H., Cramer, J., & Collins, J. (1992). A comparison of valproate with carbamazepine for the treatment of partial and secondarily generalized tonic-clonic seizures in adults. New England Journal of Medicine, 327, 765-771.
22.
McNair, D., Lorr, M., & Dropplemann, L. (1981). Profile of Mood States. San Diego, CA: Educational and Industrial Testing Service.
23.
Meador, K., Loring, D., Allen, M. E., Zamrini, E. Y., Moore, E. E., Abney, O. L., et al. (1991). Comparative cognitive effects of carbamazepine and phenytoin in healthy adults. Neurology, 41, 1537-1540.
24.
Meador, K., Loring, D., Moore, E., Thompson, W. O., Nichols, M. E., Oberzan, R. E., et al. (1995). Comparative cognitive effects of pheno-barbital, phenytoin, and valproate in healthy adults. Neurology, 45, 1494-1499.
25.
Messenheimer, J., Ramsay, R., Willmore, L., Leroy, R., Zielinski, J., Mattson, R., et al. (1994). Lamotrigine monotherapy for partial seizures: A multicenter, placebo-controlled, double-blind, cross-over trial. Epilepsia, 35, 113-121.
26.
Miller, E., Satz, P., & Visscher, B. (1991). Computerized and conventional neuropsychological assessment of HIV-1-infected homosexual men. Neurology, 41, 1608-1616.
27.
Reitan, R., & Wolfram, D. (1985). The Halstead-Reitan Neuropsychological Test Battery. Tucson, AZ: Neuropsychology Press.
28.
Rourke, S., Halman, M., & Bassel, C. (1999). Neurocognitive complaints in HIV-infection and their relationship to depressive symptoms and neuropsychological functioning. Journal of Clinical and Experimental Neuropsychology, 21, 737-756.
29.
Sachdeo, R., Reife, R., Lim, P., & Pledger, P. (1997). Topiramate monotherapy for partial onset seizures. Epilepsia, 39, 294-300.
30.
Salinsky, M., Binder, L., Dodrill, C., & Storzbach, D. (2001). Test-retest bias, reliability, and regression equations for neuropsychological measures repeated over a 12-16 week interval. Journal of the International Neuropsychological Society, 7, 597-605.
31.
Salinsky, M., Spencer, D., Oken, B., & Storzbach, D. (2004). Effects of oxcarbazepine and phenytoin on the EEG and cognition in healthy volunteers. Epilepsy Behavior, 5, 894-902.
32.
Salinsky, M., Storzbach, D., Binder, L., Arons, C., & Dodrill, C. (2002). Effects of gabapentin and carbamazepine on the EEG, alertness, and cognition in healthy volunteers. Epilepsia, 43, 482-490.
33.
Salinsky, M., Storzbach, D., Spencer, D., Oken, B., Landry, T., & Dodrill, C. (in press). Effects of topiramate and gabapentin on cognitive abilities in healthy volunteers. Neurology.
34.
Sawrie, S., Martin, R. C., Kuzniecky, R., Faught, E., Morawetz, R., Jamil, F., et al. (1999). Subjective versus objective memory change after temporal lobe surgery. Neurology, 53, 1511-1517.
35.
Schacter, S., Vazquez, B., Fisher, R., Laxer, K., Montouris, G., Combs-Cantrell, D., et al. (1999). Oxcarbazepine: Double-blind, randomized, placebo-controlled, monotherapy trial for partial seizures. Neurology, 52, 732-737.
36.
Vermuelen, J., Aldenkamp, A., & Alpherts, W. (1993). Memory complaints in epilepsy: Correlations with cognitive performance and neuroticism. Epilepsy Research, 15, 157-170.
