Effects of adjunctive perampanel on sleep quality, daytime somnolence and cognition in refractory focal epilepsy: further data.

Romigi, Andrea; Izzi, Francesca; Liguori, Claudio; Bove, Luca; Pisani, Antonio; Placidi, Fabio; Mercuri, Nicola Biagio

doi:10.1016/j.yebeh.2016.10.033

Cited by 13 publications

(7 citation statements)

References 11 publications

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“…36 Consistently, previous reports documented that PER does not worsen daytime sleepiness at 3 months. 37,38 In agreement with these data, the acceleration of EEG background activity in patients treated by PER may represent the electrophysiological basis of this finding.…”

Section: Discussionsupporting

confidence: 71%

“…Hence, this study confirms the beneficial effects of PER on vigilance and cognition. 12,13,33,38 We are aware that this study has several limitations: (a) the sample of patients included in both adult and child group, although it is in line with previous studies investigating the effect of ASMs on EEG background activity, is limited; (b) the absence of a control group; (c) the lack of administration of standard neuropsychological tests in child and adult patients to evaluate the effect of PER on cognitive functions to relate qEEG findings with neuropsychological outcomes; (d) further qEEG analyses to evaluate the reduction of spiking activity or interictal discharges in both patient types; and (e) the different comedications to which PER was added. This last issue can be resolved by a PER monotherapy study; but the indication to use PER in monotherapy in patients with epilepsy is not yet provided.…”

Section: Discussionmentioning

confidence: 99%

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Perampanel Increases Cortical EEG Fast Activity in Child and Adult Patients Affected by Epilepsy: A Quantitative EEG Study

et al. 2020

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Objective Quantitative EEG (qEEG) is an established technique used as objective measure for evaluating the effect of antiseizure medications (ASMs) on EEG background activity and monitoring cognitive effects of ASMs. Perampanel (PER) has been associated with relatively more tolerable cognitive effects in patients with epilepsy. The primary aim of the present study was to verify the effect of PER as first add-on ASM on qEEG in child and adult patients affected by epilepsy. The secondary aim of this study was to verify the effectiveness of the drug as first add-on treatment in both child and adult patients with epilepsy. Methods We collected data from 17 adults and 10 children treated with PER as first add-on treatment, who underwent qEEG analysis before starting PER and at 3-month follow-up under stable treatment. Results PER resulted with significant effectiveness in reducing seizures in both children and adults. Considering qEEG analysis, we observed at follow-up the significant increase in beta1 and beta total bands both in children and adult patients. In particular, children showed the significant increase of beta band frequencies predominantly in the occipital regions, whereas adults showed a widespread increase of beta activity. Moreover, we documented in both child and adult patients the global reduction of delta bands activity. Conclusions This qEEG study documented the relative increase of cortical EEG fast activity in both children and adult patients affected by epilepsy and treated by PER. This result may suggest a potential less negative impact of PER on cognition in patients affected by epilepsy, other than demonstrating effectiveness of the drug when used as first add-on treatment in both children and adult patients.

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Section: Discussionsupporting

confidence: 71%

Section: Discussionmentioning

confidence: 99%

Perampanel Increases Cortical EEG Fast Activity in Child and Adult Patients Affected by Epilepsy: A Quantitative EEG Study

et al. 2020

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“…Perampanel antagonizes AMPA type glutamate receptors and might be especially useful for the present case. Moreover, some studies reported that perampanel improves sleep quality, 7,8 which controls seizures. The present case would suggest that perampanel be very useful in epilepsy of patients with severe dementia due to AD.…”

Section: Discussionmentioning

confidence: 99%

A Severe Dementia Case in End of Life Care with Psychiatric Symptoms Treated by Perampanel

Kumamoto¹,

Chiba²,

Suda³

et al. 2021

J Epilepsy Res

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Epilepsy is known to comorbid with Alzheimer's disease. It can promote cognitive decline, and eventually worsen their prognosis and mortality. It is sometimes difficult to find a suitable drug because of the adverse effects. Perampanel has a unique mechanism of action that antagonizes α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid type glutamate receptor. Here, we report a case of severe dementia due to Alzheimer's disease with intractable epilepsy, which perampanel effected for controlling seizures with less adverse effects. The subject is an 89-year-old Japanese woman with severe dementia due to Alzheimer's disease and intractable myoclonic epilepsy. She also had psychiatric symptoms, such as circadian rhythm disorder and irritability. Valproic acid, lacosamide, or carbamazepine were prescribed, but none of them was effective. Shortly after perampanel started, however, myoclonus and these psychiatric symptoms improved. Moreover, it did not cause any obvious adverse effects, which made it possible to continue perampanel until the end of her life. Perampanel may be useful for controlling intractable epilepsy accompanied by Alzheimer's disease. It may also improve psychiatric symptoms with less adverse effect. Accumulation of studies is necessary to evaluate the effectiveness of perampanel on the epilepsy of Alzheimer's disease patients and further understand that mechanism.

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“…Таким образом, пристальное внимание фармацевтов и врачей привлекают взаимоотношения каждого нового ПЭП с процессом сна. На сегодняшний день зарубежными коллегами в нескольких нерандомизированных исследованиях продемонстрировано отсутствие отрицательного влияния ПЕР на качество ночного сна [13, 14] и даже отмечен возможный положительный эффект препарата [9] в отношении характеристик сна у пациентов с фокальной эпилепсией.…”

Section: динамика показателей анкетирования и псг-исследования пациенunclassified

“…Известно, что инсомния при эпилепсии служит независимым фактором повышения дневной агрессии [7], а также мощным фактором провокации эпилептических приступов [2]. В числе побочных эффектов многих противоэпилептических препаратов (ПЭП), не исключая группу новейших, присутствует влияние на сон [8][9][10]. При введении в схему терапии любого ПЭП дневная сонливость обычно интерпретируется врачами-эпилептологами как нежелательное явление (НЯ) препарата, однако она может служить проявлением синдрома беспокойных ног, сонного апноэ, метаболического синдрома, невроза, депрессии и других состояний и не быть связана с применением ПЭП [1].…”

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The use of perampanel in drug-resistant focal epilepsy: its effect on sleep

Filin

Tardov

Kunelskaya

et al. 2020

RJTAO

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Perampanel (PER) is an antiepileptic drug (AED), the effects of which on sleep have not been studied in Russia.Objective: to assess changes in the quality of sleep, the level of daytime sleepiness, and the polysomnographic (PSG) characteristics of nocturnal sleep in patients with drug-resistant focal epilepsy when PER is incorporated into the therapy regimen as an additional AED.Patients and methods. The investigation enrolled 12 patients (4 men and 8 women) aged 21 to 49 years with drug-resistant epilepsy treated with several AEDs, who had initiated therapy with PER as an additional AED. PSG study and questioning survey were done before and 1 month after initiation of PER therapy.Results and discussion. After one month of PER therapy, there was an increase in the quality of night sleep in 5 cases and a reduction in daytime sleepiness in 6 cases. The PSG pattern was stable in 3 patients, worsened in 1, and improved in 8.Conclusion. The preliminary results suggest that PER therapy improves night sleep quality and reduces daytime sleepiness in about half of the cases, as evidenced by the improved PSG pattern in 67% of patients.

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Effects of adjunctive perampanel on sleep quality, daytime somnolence and cognition in refractory focal epilepsy: further data.

Cited by 13 publications

References 11 publications

Perampanel Increases Cortical EEG Fast Activity in Child and Adult Patients Affected by Epilepsy: A Quantitative EEG Study

Perampanel Increases Cortical EEG Fast Activity in Child and Adult Patients Affected by Epilepsy: A Quantitative EEG Study

A Severe Dementia Case in End of Life Care with Psychiatric Symptoms Treated by Perampanel

The use of perampanel in drug-resistant focal epilepsy: its effect on sleep

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