Liguori Claudio, Spanetta Matteo, Izzi Francesca, Russo Angelo, Guerra Angelo, Mercuri Nicola Biagio, Placidi Fabio
Epilepsy Centre, Neurology Unit, Department of Systems Medicine, University of Rome "Tor Vergata," Rome, Italy.
IRCSS Istituto delle Scienze Neurologiche di Bologna, UOC Neuropsichiatria, Bologna, Italy.
Clin EEG Neurosci. 2021 Sep;52(5):360-370. doi: 10.1177/1550059420947936. Epub 2020 Aug 7.
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.
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.
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.
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.
定量脑电图（qEEG）是一种既定技术，用作评估抗癫痫药物（ASM）对脑电图背景活动的影响以及监测ASM认知效应的客观指标。吡仑帕奈（PER）与癫痫患者相对更可耐受的认知效应相关。本研究的主要目的是验证PER作为首次添加的ASM对癫痫患儿和成人患者qEEG的影响。本研究的次要目的是验证该药物作为癫痫患儿和成人患者首次添加治疗的有效性。
我们收集了17名成人和10名儿童的数据，这些患者接受PER作为首次添加治疗，在开始PER治疗前以及稳定治疗3个月随访时接受了qEEG分析。
PER在减少儿童和成人癫痫发作方面均有显著疗效。考虑qEEG分析，我们在随访中观察到儿童和成人患者的β1和总β频段均显著增加。特别是，儿童主要在枕叶区域β频段频率显著增加，而成人则表现为β活动广泛增加。此外，我们记录到儿童和成人患者的δ频段活动总体减少。
这项qEEG研究记录了癫痫患儿和成人患者接受PER治疗后皮质脑电图快速活动的相对增加。这一结果可能表明PER对癫痫患者认知的潜在负面影响较小，同时也证明了该药物作为儿童和成人患者首次添加治疗的有效性。
