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

Liguori, Claudio; Spanetta, Matteo; Izzi, Francesca; Russo, Angelo; Guerra, Angelo; Mercuri, Nicola Biagio; Placidi, Fabio

doi:10.1177/1550059420947936

Cited by 15 publications

(11 citation statements)

References 38 publications

(74 reference statements)

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“…6), a characteristic oscillation response of the sensorimotor cortex to TMS 51 , and the component is expressed only in the first 100 ms, which is the typical duration of local oscillatory responses 51 . The increase of this tensor by perampanel is consistent with enhancing effects on beta-band power detected with resting-state magnetoencephalography (MEG) 52 in healthy subjects, and in resting-state EEG of patients with epilepsy 53 . In contrast, the second tensor component involved medial parietal channels with a time course lasting for the whole 400 ms of the analysis window, and low-alpha as main frequency content.…”

Section: Increase Of Tms-induced Eeg Oscillations (Tios) In the Stimulated Sensorimotor Cortex And Medial Parietal Areas By Perampanelsupporting

confidence: 74%

TMS-EEG signatures of glutamatergic neurotransmission in the human cortex

et al. 2019

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Neuronal activity in the brain reflects an excitation-inhibition balance that is regulated predominantly by glutamatergic and GABAergic neurotransmission, and often disturbed in neuropsychiatric disorders. Here, we tested the effects of a single oral dose of two anti-glutamatergic drugs (dextromethorphan, an NMDA receptor antagonist; perampanel, an AMPA receptor antagonist) and an L-type voltage-gated calcium channel blocker (nimodipine) on transcranial magnetic stimulation (TMS)-evoked electroencephalographic (EEG) potentials (TEPs) and TMS-induced oscillations (TIOs) in 16 healthy adults in a pseudorandomized, double-blinded, placebo-controlled crossover design. Single-pulse TMS was delivered to the hand area of left primary motor cortex. Dextromethorphan increased the amplitude of the N45 TEP, while it had no effect on TIOs. Perampanel reduced the amplitude of the P60 TEP in the non-stimulated hemisphere, and increased TIOs in the beta-frequency band in the stimulated sensorimotor cortex, and in the alpha-frequency band in midline parietal channels. Nimodipine and placebo had no effect on TEPs and TIOs. The TEP results extend previous pharmaco-TMS-EEG studies by demonstrating that the N45 is regulated by a balance of GABAAergic inhibition and NMDA receptor-mediated glutamatergic excitation. In contrast, AMPA receptormediated glutamatergic neurotransmission contributes to propagated activity reflected in the P60 potential and midline parietal induced oscillations. This pharmacological characterization of TMS-EEG responses will be informative for interpreting TMS-EEG abnormalities in neuropsychiatric disorders with pathological excitation-inhibition balance.Transcranial magnetic stimulation applied during electroencephalographic recording (TMS-EEG) is a powerful technique to access excitability of the targeted brain area and effective connectivity to distant sites in healthy and in pathological conditions 1 . TMS-EEG is also emerging as an effective tool to examine impaired inhibitory and excitatory neurotransmission underlying a broad variety of brain disorders, such as epilepsy, schizophrenia, or Alzheimer's disease 2-5 . To fully exploit clinical translation of TMS-EEG requires a solid physiological characterization of TMS-EEG responses, e.g., in pharmaco-TMS-EEG experiments using drugs with specific modes of action in the central nervous system.EEG responses to TMS can be interrogated in the time 6 and time-frequency domains 7 , providing complementary information about cortical processes 8 . The responses in the time domain are referred to as TMS-evoked EEG potentials (TEPs), which consist of a reliable alternating sequence of positive (P) and negative (N) peaks at approximately 30 (P30), 45 (N45), 60 (P60), 100 (N100) and 180 (P180) milliseconds after the TMS pulse when targeting the primary motor cortex (M1) 6 . Time-frequency decomposition reveals TMS-induced oscillations (TIOs) which, in contrast to TEPs, display responses not time-locked to the TMS pulse 9 . Their typical profile following M1 stimulati...

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Section: Increase Of Tms-induced Eeg Oscillations (Tios) In the Stimulated Sensorimotor Cortex And Medial Parietal Areas By Perampanelsupporting

confidence: 74%

TMS-EEG signatures of glutamatergic neurotransmission in the human cortex

et al. 2019

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“…However, there are also some patients whose treatment effects are not satisfactory. Patients should make clinical diagnoses regularly and choose the stopping time according to the diagnosis results [ 27 ].…”

Section: Discussionmentioning

confidence: 99%

Prediction Value of Epilepsy Secondary to Inferior Cavity Hemorrhage Based on Scalp EEG Wave Pattern in Deep Learning

Jiang

2022

Journal of Healthcare Engineering

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Objective. To search the predictive value of epilepsy secondary to acute subarachnoid hemorrhage (aSAH) based on EEG wave pattern in deep learning. Methods. A total of 156 cases of secondary epilepsy with lower cavity hemorrhage in our hospital were selected and divided into the late epilepsy group and the early epilepsy group according to seizure time, and the nonseizure group and the seizure group according to seizure condition. General data of patients were collected, the EEG types of each group were analyzed, and the disease recurrence rate, treatment effect, and symptom onset time were compared. Results. Rapid and slow and rapid blood flow velocity were the main abnormal manifestations of epilepsy secondary to inferior cavity hemorrhage, accounting for 33.3% and 18.6%, respectively. Compared with the seizure group, the proportion of type ii and type iii in the nonseizure group was higher, and the proportion of type ii and type iii in the early epilepsy group was higher than in the late epilepsy group ( P < 0.05). The diagnostic accuracy, missed diagnosis rate, misdiagnosis rate, specificity, and sensitivity of the EEG wave pattern were 94.9%, 3.2%, 1.9%, 91.7%, and 96.2%, respectively. Compared with the early epilepsy group, the recurrence rate of type iii and type iv in the late epilepsy group was higher ( P < 0.05). The effective rates of the attack group and the nonattack group were 72.7% and 97.0%, respectively. Compared with the attack group, the effective rate of the nonattack group was higher ( P < 0.05). The effective rates of the early epilepsy group and the late epilepsy group were 91.7% and 85.0%, respectively. Compared with the late epilepsy group, the effective rate of the early epilepsy group was higher ( P < 0.05). Compared with the early epilepsy group, the late epilepsy group had longer tonic-clonic seizures, atonic seizures, and absent seizures, and the difference between the groups was statistically significant ( P < 0.05). Conclusion. In aSAH secondary epilepsy disease prediction, based on indepth study of the scalp EEG wave type prediction, they play an important role, including aSAH high-risk secondary epilepsy wave types for V, III, and IV types, as well as early and late epilepsy associated with disease stage. Through the diagnosis method to predict the severity of disease, this builds a good foundation for clinical treatment. It is beneficial to improve the effective rate of treatment.

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“…7 However, another study using EEG spectral analysis reported an increase in cortical EEG fast activity, with an increase in the beta band and a decrease in the delta band in adults and children after three months of follow-up, indicating potential enhancement of attention and cognition. 8 Although previous studies using comprehensive NP tests, a gold standard for examining cognitive function, have reported little or no change in cognition after perampanel treatment, significant changes in the power of brain oscillations were observed. Considering that brain oscillations are more sensitive than clinical measures, further investigation is needed to evaluate the effect of perampanel on brain activity.…”

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confidence: 92%