The effect of Perampanel on EEG spectral power and connectivity in patients with focal epilepsy

Lanzone, Jacopo; Ricci, Lorenzo; Tombini, Mario; Boscarino, Marilisa; Mecarelli, Oriano; Pulitano, Patrizia; Lazzaro, Vincenzo Di; Assenza, Giovanni

doi:10.1016/j.clinph.2021.05.026

Cited by 25 publications

(20 citation statements)

References 44 publications

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“…However, fMRI studies only retain low-frequency amplitudes, and may lose high-frequency information of neural activity (Wang et al, 2014). Also, studies that are based on fMRI and electroencephalogram show that brain activity exhibit frequencydependent properties (Gohel and Biswal, 2015;Jiang et al, 2019;Jun et al, 2019;Lanzone et al, 2021b). Magnetoencephalography (MEG) is a non-invasive technique with high spatiotemporal resolution that records brain activity by detecting magnetic fields generated by neural currents (Guggisberg et al, 2008;Burgess, 2011).…”

Section: Introductionmentioning

confidence: 99%

Impact of Antiepileptic Drugs on Cognition and Neuromagnetic Activity in Childhood Epilepsy With Centrotemporal Spikes: A Magnetoencephalography Study

Niu

Zhang

et al. 2021

Front. Hum. Neurosci.

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Objective: Childhood epilepsy with centrotemporal spikes (CECTS), the most common childhood epilepsy, still lacks longitudinal imaging studies involving antiepileptic drugs (AEDs). In order to examine the effect of AEDs on cognition and brain activity. We investigated the neuromagnetic activities and cognitive profile in children with CECTS before and after 1 year of treatment.Methods: Fifteen children with CECTS aged 6–12 years underwent high-sampling magnetoencephalography (MEG) recordings before treatment and at 1 year after treatment, and 12 completed the cognitive assessment (The Wechsler Intelligence Scale for Children). Next, magnetic source location and functional connectivity (FC) were investigated in order to characterize interictal neuromagnetic activity in the seven frequency sub-bands, including: delta (1–4 Hz), theta (4–8 Hz), alpha (8–12 Hz), beta (12–30 Hz), gamma (30–80 Hz), ripple (80–250 Hz), and fast ripple (250–500 Hz).Results: After 1 year of treatment, children with CECTS had increased scores on full-scale intelligence quotient, verbal comprehension index (VCI) and perceptual reasoning index (PRI). Alterations of neural activity occurred in specific frequency bands. Source location, in the 30–80 Hz frequency band, was significantly increased in the posterior cingulate cortex (PCC) after treatment. Moreover, FC analysis demonstrated that after treatment, the connectivity between the PCC and the medial frontal cortex (MFC) was enhanced in the 8–12 Hz frequency band. Additionally, the whole-brain network distribution was more dispersed in the 80–250 Hz frequency band.Conclusion: Intrinsic neural activity has frequency-dependent characteristic. AEDs have impact on regional activity and FC of the default mode network (DMN). Normalization of aberrant DMN in children with CECTS after treatment is likely the reason for improvement of cognitive function.

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Section: Introductionmentioning

confidence: 99%

Impact of Antiepileptic Drugs on Cognition and Neuromagnetic Activity in Childhood Epilepsy With Centrotemporal Spikes: A Magnetoencephalography Study

Niu

Zhang

et al. 2021

Front. Hum. Neurosci.

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“… Li et al (2022) have constructed a model combining the clinical and PLV EEG features to diagnose Alzheimer’s disease (AD), which exhibits satisfactory performance and robustness. Another study ( Lanzone et al, 2021 ) has found that PLV EEG in the α band of patients who were effective on treatment with perampanel as an add-on drug could be used as a biomarker to predict the responsiveness to perampanel drugs. Cho et al (2017) have reported that PLV EEG in the γ band may be a potential biomarker for predicting seizures.…”

Section: Discussionmentioning

confidence: 99%

An objective model for diagnosing comorbid cognitive impairment in patients with epilepsy based on the clinical-EEG functional connectivity features

et al. 2023

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ObjectiveCognitive impairment (CI) is a common disorder in patients with epilepsy (PWEs). Objective assessment method for diagnosing CI in PWEs would be beneficial in reality. This study proposed to construct a diagnostic model for CI in PWEs using the clinical and the phase locking value (PLV) functional connectivity features of the electroencephalogram (EEG).MethodsPWEs who met the inclusion and exclusion criteria were divided into a cognitively normal (CON) group (n = 55) and a CI group (n = 76). The 23 clinical features and 684 PLVEEG features at the time of patient visit were screened and ranked using the Fisher score. Adaptive Boosting (AdaBoost) and Gradient Boosting Decision Tree (GBDT) were used as algorithms to construct diagnostic models of CI in PWEs either with pure clinical features, pure PLVEEG features, or combined clinical and PLVEEG features. The performance of these models was assessed using a five-fold cross-validation method.ResultsGBDT-built model with combined clinical and PLVEEG features performed the best with accuracy, precision, recall, F1-score, and an area under the curve (AUC) of 90.11, 93.40, 89.50, 91.39, and 0.95%. The top 5 features found to influence the model performance based on the Fisher scores were the magnetic resonance imaging (MRI) findings of the head for abnormalities, educational attainment, PLVEEG in the beta (β)-band C3-F4, seizure frequency, and PLVEEG in theta (θ)-band Fp1-Fz. A total of 12 of the top 5% of features exhibited statistically different PLVEEG features, while eight of which were PLVEEG features in the θ band.ConclusionThe model constructed from the combined clinical and PLVEEG features could effectively identify CI in PWEs and possess the potential as a useful objective evaluation method. The PLVEEG in the θ band could be a potential biomarker for the complementary diagnosis of CI comorbid with epilepsy.

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“…Since PER is effective in treating both focal-onset and generalized-onset seizures, it is considered to have broad-spectrum potential [ 33,34]. Indeed, neurophysiological studies suggest that PER's efficacy for both focal-and generalized-onset seizures may be due to its inhibitory action on thalamocortical pathways in types of epilepsy characterized by thalamocortical hyperexcitability [35,36]. A recent systemic review analyzed clinical data on PER in the treatment of generalized seizures, including a total of 91 reports/studies [37].…”

Section: Discussionmentioning

confidence: 99%

Perampanel Monotherapy for Focal and Generalized Epilepsy in Clinical Practice

Chinvarun

Delgado

Astner-Rohracher

et al. 2023

Acta Neurologica Scandinavica

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Objectives. To investigate the effectiveness, safety, and tolerability of perampanel (PER) when used as monotherapy to treat focal or generalized epilepsy in everyday clinical practice, using data from the PERMIT study. Methods. PERMIT was a pooled analysis of 44 real-world studies from 17 countries, in which people with focal and generalized epilepsy were treated with PER. This post hoc analysis included people with epilepsy (PWE) from PERMIT who were treated with PER monotherapy at baseline. Retention and effectiveness were assessed after 3, 6, and 12 months. Effectiveness assessments included ≥50% responder rate and seizure freedom rate (no seizures since at least the prior visit). Safety and tolerability were assessed by evaluating adverse events (AEs) and discontinuation due to AEs. Results. Overall, 268 PWE were treated with PER monotherapy at baseline. Retention was assessed for 168 PWE, effectiveness for 183 PWE, and safety and tolerability for 197 PWE. Retention rates were 91.1%, 87.3%, and 73.3% at 3, 6, and 12 months, respectively. At 12 months, responder rates were 84.2% overall, 82.9% in PWE with only focal-onset seizures at baseline, and 88.0% in those with only generalized-onset seizures at baseline; corresponding freedom rates were 62.9%, 57.7%, and 80.0%, respectively. AEs were reported for 45.2% of PWE. The most frequently reported AEs (≥5% of PWE) were dizziness/vertigo (16.8%), irritability (11.2%), somnolence (9.1%), and depression (6.6%). Over 12 months, 13.7% discontinued due to AEs. Conclusions. PER was effective when used as monotherapy in clinical practice, particularly in those with generalized-onset seizures, and was generally well tolerated.

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The effect of Perampanel on EEG spectral power and connectivity in patients with focal epilepsy

Cited by 25 publications

References 44 publications

Impact of Antiepileptic Drugs on Cognition and Neuromagnetic Activity in Childhood Epilepsy With Centrotemporal Spikes: A Magnetoencephalography Study

Impact of Antiepileptic Drugs on Cognition and Neuromagnetic Activity in Childhood Epilepsy With Centrotemporal Spikes: A Magnetoencephalography Study

An objective model for diagnosing comorbid cognitive impairment in patients with epilepsy based on the clinical-EEG functional connectivity features

Perampanel Monotherapy for Focal and Generalized Epilepsy in Clinical Practice

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