Changes in balance function with chronic antiepileptic drug therapy: A twin and sibling study

Journal article


Ahmad, Baemisla Shiek, Wark, John D., Petty, Sandra J., O'Brien, Terence J., Gorelik, Alexandra, Sambrook, Philip N. and Hill, Keith D.. (2015) Changes in balance function with chronic antiepileptic drug therapy: A twin and sibling study. Epilepsia. 56(11), pp. 1714 - 1722. https://doi.org/10.1111/epi.13136
AuthorsAhmad, Baemisla Shiek, Wark, John D., Petty, Sandra J., O'Brien, Terence J., Gorelik, Alexandra, Sambrook, Philip N. and Hill, Keith D.
Abstract

Objective To investigate cross‐sectional and longitudinal differences in static and dynamic standing balance measures and lower limb muscle strength in patients who are treated chronically with antiepileptic drugs (AEDs). Methods Twenty‐six AED exposure–discordant same‐gender twin and sibling pairs were studied. Clinical and laboratory balance examinations were conducted twice, separated by at least 1 year. The mean within‐pair differences in balance measures were calculated cross‐sectionally at baseline and follow‐up, and longitudinally. Results No significant mean within‐pair difference was found at baseline in age (44 years), weight, and height (p > 0.05). Between study assessments, the median (interquartile range [IQR]) interval was 3.0 (2.1–4.3) years in users and 2.9 (2.0–4.4) years in nonusers. The median duration of AED therapy was 19 (11–21) years. At baseline and follow‐up, cross‐sectional sway measures from posturography (Chattecx Balance System) and clinical static balance tests showed poorer performance in users compared to nonusers on several test conditions (p = 0.002–0.032). At follow‐up, the users took longer than nonusers to complete the Four‐Square‐Step Test (p = 0.005) and Five‐Times‐Sit‐to‐Stand Test (p = 0.018). A greater annual rate of deterioration in sway was found in users compared to nonusers using posturography on the anteroposterior tilting platform task with distraction (p = 0.032). In both groups, higher baseline sway predicted greater annual deterioration in sway in all platform conditions (β = 0.3–0.5, p < 0.001–0.013). The annual change in measures did not differ between groups in the clinical balance and lower limb strength assessments. Significance In this longitudinal twin and sibling study, chronic AED users had poorer standing balance compared to nonusers. Users showed greater deterioration in postural sway with one dynamic platform condition. AEDs may progressively impair balance mechanisms, although this requires further investigations. Repeated dynamic posturography could provide a basis for preventive trials for maintaining or improving balance.

Keywordsbalance; postural sway; antiepileptic drugs; epilepsy; cohort study; twin/sibling
Year2015
JournalEpilepsia
Journal citation56 (11), pp. 1714 - 1722
PublisherWiley-Blackwell
ISSN0013-9580
Digital Object Identifier (DOI)https://doi.org/10.1111/epi.13136
Scopus EID2-s2.0-84945894871
Page range1714 - 1722
Research GroupSchool of Philosophy
Publisher's version
File Access Level
Controlled
Place of publicationUnited States of America
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Bohensky, Megan A., Barker, Anna, Morello, Renata Teresa, De Steiger, Richard N., Gorelik, Alexandra and Brand, Caroline A.. (2014) Geographical variation in incidence of knee arthroscopy for patients with osteoarthritis: A population-based analysis of Victorian hospital separations data. Internal Medicine Journal. 44(6), pp. 537 - 545. https://doi.org/10.1111/imj.12438
Thyroid surgery and anticoagulation: Survey of practice of endocrine surgeons in Australia
Verma, Kunal Pradip, Gorelik, Alexandra and Miller, Julie A.. (2013) Thyroid surgery and anticoagulation: Survey of practice of endocrine surgeons in Australia. World Journal of Endocrine Surgery. 5(1), pp. 6 - 11. https://doi.org/10.5005/jp-journals-10002-1115
Primary angiitis of the central nervous system: Experience of a Victorian tertiary-referral hospital
Oon, S., Roberts, Carol, Gorelik, Alexandra, Wicks, I. and Brand, Caroline A.. (2013) Primary angiitis of the central nervous system: Experience of a Victorian tertiary-referral hospital. Internal Medicine Journal. 43(6), pp. 685 - 692. https://doi.org/10.1111/imj.12038
Outcomes and excess costs among patients with cardiovascular disease
Ademi, Zanfina, Liew, Danny, Zomer, Ella, Gorelik, Alexandra, Hollingsworth, Bruce, Steg, Philippe Gabriel, Bhatt, Deepak L. and Reid, Christopher M.. (2013) Outcomes and excess costs among patients with cardiovascular disease. Heart Lung and Circulation. 22(9), pp. 724 - 730. https://doi.org/10.1016/j.hlc.2013.02.002
Epidemiology of hepatitis B-associated hepatocellular carcinoma in Victoria
Sinclair, M., Roberts, S., Kemp, W., Knight, V., Dev, A., Gow, P., Philpott, H., Kronborg, Ian, Arachchi, Niranjan J., Bell, Sally J., Lim, Lucy, Gorelik, Alexandra and Nicoll, Amanda J.. (2013) Epidemiology of hepatitis B-associated hepatocellular carcinoma in Victoria. Internal Medicine Journal. 43(5), pp. 501 - 506. https://doi.org/10.1111/imj.12068
Who, why and when: Stroke care unit patients seen by a palliative care service within a large metropolitan teaching hospital
Eastman, Peter, McCarthy, Gillian, Brand, Caroline A., Weir, Louise, Gorelik, Alexandra and Le, Brian. (2013) Who, why and when: Stroke care unit patients seen by a palliative care service within a large metropolitan teaching hospital. BMJ Supportive and Palliative Care. 3(1), pp. 77 - 83. https://doi.org/10.1136/bmjspcare-2012-000331