Department of Neurology, School of Medicine, Kyungpook National University, Daegu, Korea.
J Clin Neurol. 2009 Dec;5(4):178-85. doi: 10.3988/jcn.2009.5.4.178. Epub 2009 Dec 31.
Levetiracetam (LEV) is an antiepileptic drug (AED) that has favorable effects on cognition. Although neuropsychological studies have demonstrated these favorable outcomes on cognition, there are few electrophysiologic data describing the functional changes exerted by LEV. The purpose of this study was to determine the effects of LEV adjunctive therapy on the current-source density (CSD) in the high beta frequency band (22-30 Hz) of EEG background activity in refractory partial epilepsy (RPE).
We conducted a 24-week, open-label, prospective study in 24 patients with RPE. Scalp electroencephalography and neuropsychological tests (NPTs) were conducted twice, once before the LEV trial and then again after 24 weeks of medication.
The CSD in the 22-30 Hz band of EEG background activity increased in the bilateral anterior cingulate gyri, left parahippocampal gyrus, and a small area of the right anterior parahippocampal gyrus after the LEV trial. Neither seizure freedom nor the dosage increment of LEV elicited meaningful CSD changes. Verbal memory and executive function were improved after the 24-week LEV trial.
To our knowledge, this is the first study to examine the changes in CSD induced by LEV adjunctive therapy in RPE patients. The CSD changes and NPT results suggest that LEV enhances the activities of the neuronal networks in the prefrontal cortex and left hippocampus.
左乙拉西坦（LEV）是一种抗癫痫药物（AED），对认知功能有积极影响。尽管神经心理学研究已经证明了这些对认知的有利结果，但很少有描述 LEV 施加的功能变化的电生理数据。本研究的目的是确定 LEV 辅助治疗对难治性部分性癫痫（RPE）患者脑电图背景活动中高 beta 频带（22-30 Hz）的电流源密度（CSD）的影响。
我们进行了一项为期 24 周、开放标签、前瞻性的研究，纳入了 24 例 RPE 患者。在 LEV 试验前和 24 周药物治疗后两次进行头皮脑电图和神经心理学测试（NPT）。
LEV 试验后，脑电图背景活动中 22-30 Hz 频段的 CSD 在双侧前扣带回、左海马旁回和右侧海马旁回的一小部分区域增加。LEV 剂量增加或癫痫无发作均未引起有意义的 CSD 变化。在 24 周的 LEV 试验后，言语记忆和执行功能得到改善。
据我们所知，这是第一项研究 LEV 辅助治疗对 RPE 患者 CSD 变化的影响的研究。CSD 变化和 NPT 结果表明，LEV 增强了前额叶皮层和左侧海马的神经网络活动。
