López-Góngora Mariana, Martínez-Domeño Alejandro, García Carmen, Escartín Antonio
Department of Neurology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona Spain.
Epileptic Disord. 2008 Dec;10(4):297-305. doi: 10.1684/epd.2008.0227.
The purpose of the study was to assess changes in cognitive functions and quality of life in patients with epilepsy over one year of treatment with levetiracetam (LEV) as add-on therapy.
Thirty-two patients (16 women; 16 men) who received LEV as an add-on treatment were included, and 27 completed the one-year follow-up period. Extensive neuropsychological assessments, together with a quality-of-life questionnaire were administered at baseline and at one, three, six and twelve months after beginning the add-on treatment. Patients received LEV starting with 500 mg/day in the first week, increasing by a further 500 mg/day per week until a target dose of 2 000 mg/day was reached by the end of the first month.
At the one-year follow-up, a significant improvement was observed in measurements of prospective memory, working memory, motor functions, verbal fluency, attention and quality of life. Performance for neuropsychological and quality-of-life tests was not affected by external variables such as seizure reduction or changes in previous anti-epileptic treatment. Slight changes between patients were observed, but these were not clinically significant.The limited sample size and the lack of a control group should be mentioned as limitations of the study. No control group was evaluated as in our clinical practice it was difficult to establish a comparable group of patients. Changes in the different variables were assessed by comparing baseline information with follow-up results.Despite the study limitations, we consider that the one-year treatment period provides valuable information regarding the drug's long-term effects in this setting.
Results of the present study suggest that long-term LEV treatment as add-on therapy does not interfere with cognitive function and improves quality of life.
本研究旨在评估左乙拉西坦(LEV)作为附加疗法治疗癫痫患者一年期间认知功能和生活质量的变化。
纳入32例接受LEV附加治疗的患者(16例女性;16例男性),其中27例完成了一年的随访期。在开始附加治疗的基线以及治疗后1个月、3个月、6个月和12个月时,进行了广泛的神经心理学评估以及生活质量问卷调查。患者第一周开始服用LEV,剂量为500毫克/天,每周增加500毫克/天,直至第一个月末达到目标剂量2000毫克/天。
在一年的随访中,前瞻性记忆、工作记忆、运动功能、语言流畅性、注意力和生活质量的测量结果有显著改善。神经心理学和生活质量测试的表现不受癫痫发作减少或先前抗癫痫治疗变化等外部变量的影响。观察到患者之间有轻微变化,但这些变化在临床上并不显著。应提及样本量有限和缺乏对照组是本研究的局限性。由于在我们的临床实践中难以建立一个可比的患者组,因此未评估对照组。通过比较基线信息和随访结果来评估不同变量的变化。尽管存在研究局限性,但我们认为一年的治疗期提供了有关该药物在此情况下长期效果的有价值信息。
本研究结果表明,长期使用LEV作为附加疗法不会干扰认知功能,反而能改善生活质量。