Department of Epileptology, University Hospital Bonn (UKB), Bonn, Germany.
Department of Epileptology, University Hospital Bonn (UKB), Bonn, Germany.
Seizure. 2022 Jan;94:107-111. doi: 10.1016/j.seizure.2021.12.001. Epub 2021 Dec 4.
This systematic review was conducted to reveal the cognitive effects of perampanel (PER) as assessed by objective standardized neuropsychological measures in patients with epilepsy. A systematic literature search was performed in PubMed. In addition we cross-checked a list of relevant studies (based on a ProQuest search) provided by Eisai GmbH. Eligibility criteria were (1) group studies reporting the cognitive outcome of treatment with PER in patients with epilepsy (2) which employed objective cognitive tests and (3) were published in English. Of the 56 initially retrieved records, 9 eligible studies were included in the qualitative synthesis. Two studies were based on the very same sample. Altogether the included studies analyzed a total of 241 patients (46% pediatric) with adjunctive PER. All studies were longitudinal with assessments before and after introduction of PER (up to 5 follow-ups and observation intervals of up to 1 year). Two studies were retrospective, 6 lacked a control condition. Neuropsychological assessments varied in extent and test selection. Overall no systematic cognitive deteriorations or improvements after introduction of PER have been reported across the analyzed studies. The only randomized placebo-controlled trial found a transient worsening in attention and speed of memory at the 19-week follow-up, and in addition a late decline in another parameter of attention at the final 52-week follow-up. This systematic review on the objective cognitive effects of PER suggests an overall neutral cognitive profile of PER with no systematic cognitive deteriorations or improvements. More controlled studies on the cognitive effects of PER would be appreciated.
本系统评价旨在揭示吡仑帕奈（PER）对癫痫患者认知影响的客观评估，采用了标准化神经心理学测试。我们在 PubMed 上进行了系统的文献检索。此外，我们还交叉检查了 Eisai GmbH 提供的相关研究列表（基于 ProQuest 搜索）。纳入标准为：（1）组研究报告了 PER 治疗癫痫患者的认知结果；（2）采用客观认知测试；（3）以英文发表。在最初检索到的 56 条记录中，有 9 项符合条件的研究纳入了定性综合分析。其中两项研究基于相同的样本。总共纳入的研究分析了共 241 名（46%为儿童）接受辅助 PER 治疗的患者。所有研究均为纵向研究，在 PER 引入前后进行评估（最多 5 次随访，观察时间最长达 1 年）。两项研究为回顾性研究，6 项研究缺乏对照条件。神经心理学评估的范围和测试选择存在差异。总体而言，分析的研究均未报告 PER 引入后出现系统性认知恶化或改善。唯一的随机安慰剂对照试验发现，在 19 周随访时注意力和记忆速度短暂恶化，此外在最终的 52 周随访时，另一个注意力参数也出现晚期下降。本系统评价关于 PER 的客观认知影响的研究结果表明，PER 的总体认知特征为中性，没有系统性认知恶化或改善。需要更多关于 PER 认知影响的对照研究。
