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November 18, 2015
AED Therapy Tied to Deteriorating Balance in
Small Study of Siblings Victoria, Australia—Over years of use, antiepileptic drug therapy appears to cause deteriorating balance, according to a small study of 26 twin and sibling pairs. The research, which used static and dynamic balance tests to compare participants who used AEDs to their siblings, was published in the journal Epilepsia. Study authors from the University of Melbourne note that the sway tests showed deteriorating balance over 3 years of testing. Researchers emphasize that addressing the balance issues in patients taking antiepileptic drugs could help reduce their risk of falling, which can lead to fractures and other injuries. “Use of the powerful discordant-pair study design enabled detection of these clinically-significant changes,” said co-author John D. Wark, PhD in a Wiley press release. “The finding of progressive impairment of balance function underlines the need for further research as well as alerting clinicians to this important issue for patients on long-term antiepileptic drug therapy.” For the study, clinical and laboratory balance examinations were conducted twice, separated by at least a year. At baseline, no significant difference was found within the pairs at weight, height or age—a median of 44. The duration of AED therapy averaged 19 years for those on the drugs.. Yet, at baseline and follow-up, cross-sectional sway measures from posturography, and clinical static balance tests showed poorer performance in users compared to nonusers on several test conditions. At follow-up, meanwhile, AED users took longer than nonusers to complete the Four-Square-Step Test and Five-Times-Sit-to-Stand Test, the researchers note. In addition, 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. In both groups, according to study authors, higher baseline sway predicted greater annual deterioration in sway in all platform conditions. The annual change in measures did not differ between groups in the clinical balance and lower limb strength assessments, however. “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,” study authors conclude. “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.”
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