Cenobamate & Cognition in Tuberous Sclerosis Complex (TSC) – 12-Month Outcomes

by Grace Chen

Cenobamate Shows Promise in Improving Quality of Life for Adults with Tuberous Sclerosis Complex and Epilepsy

A new study indicates that adding cenobamate to existing treatment plans considerably improved executive function, quality of life, and reduced stress levels in adults living with tuberous sclerosis complex (TSC) and drug-resistant epilepsy.

Did you know? — tuberous sclerosis complex (TSC) is a rare genetic disorder that causes benign tumors to grow in various organs, including the brain.

Cenobamate, a relatively new medication for epilepsy, has demonstrated potential benefits extending beyond seizure control, particularly in individuals with complex neurogenetic conditions like TSC. A prospective observational study, the results of which are expected to be published in Neurology Therapeutics in July 2026, evaluated the neuropsychological and psychosocial effects of cenobamate when used as an add-on therapy for late adolescents and young adults with TSC and drug-resistant epilepsy.

Assessing the Impact of Cenobamate

The research team followed 22 patients between the ages of 18 and 24 who initiated cenobamate treatment to better manage their seizures. Participants underwent standardized assessments at the beginning of the study, and again at 3 and 12 months, with a focus on executive function, adaptive behavior, quality of life, and parental stress. Further cognitive testing was conducted at the 12-month mark to monitor stability over time.

Pro tip — Executive function encompasses skills like planning, association, and working memory, crucial for daily life.

Meaningful Improvements Observed in Key Areas

Over the course of the year-long study, researchers reported statistically significant improvements in executive function — as measured by the Epitrack assessment — and also in quality of life scores and measures of parental stress after either 3 or 12 months of cenobamate add-on therapy. Importantly, broader cognitive performance and adaptive behavior remained stable, indicating no overall cognitive decline during the observation period.

The analysis also revealed intriguing connections within the study group. Patients with TSC2 mutations exhibited significantly lower IQ scores compared to those with TSC1 mutations. Furthermore,a strong correlation was observed between parental stress and adaptive behavior scores both at the start of the study and after 12 months,underscoring the interplay between daily functioning and the challenges faced by caregivers.

Reader question — How might improved executive function translate to better outcomes for individuals with TSC in everyday settings?

Implications for Clinical Practice

“Taken together, the findings suggest cenobamate add-on therapy was effective and generally well tolerated in this small cohort,†one analyst noted. The observed benefits spanned multiple areas, including executive functioning, emotional well-being, social functioning, quality of life, and caregiver stress. The study authors beleive these findings could inform clinical decision-making, potentially leading to earlier consideration of cenobamate as a treatment option for patients with TSC experiencing drug-resistant epilepsy.

The full study, “Long-Term Impact of Cenobamate on Cognition, Adaptive Behavior, and Quality of Life in Patients with Tuberous Sclerosis Complex,†is available via DOI: 10.1007/s40120-026-00894-3.

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