Effects of levetiracetam and oxcarbazepine monotherapy on intellectual and cognitive development in children with benign epilepsy with centrotemporal spikes

Suo, Guihai; Zheng, Yuxin; Wu, Youjia; Tang, Jihong

doi:10.1007/s13760-021-01613-5

Cited by 8 publications

(15 citation statements)

References 27 publications

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“…Oxcarbazepine is currently the first-line drug used to treat partial epilepsy in children with good efficacy and safety and so it has been recognized by clinicians and children's families. However, in recent years, its effect on the improvement of patients' cognitive function is still controversial [ 10 ]. Levetiracetam is a newly developed AED in recent years.…”

Section: Introductionmentioning

confidence: 99%

Influence of Different Antiepileptic Drugs on Blood Ammonia and Homocysteine Levels in Children with Epilepsy

Sun

Zhou

Wang

et al. 2021

Evidence-Based Complementary and Alternative Medicine

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In this study, we performed a study on 106 children with epilepsy who were treated with sodium valproate (the VPA group, n = 37), oxcarbazepine (the OXC group, n = 34), or levetiracetam (the LEV group, n = 35). In addition, the clinical data of epileptic children who were newly diagnosed in the same period without antiepileptic drug (AED) treatment (the untreated group, n = 35) and normal children who received physical examination in our hospital (the healthy group, n = 35) were selected as controls. We analyzed the efficacy and safety of different AEDs, used blood ammonia and homocysteine levels as the observation indicators, and calculated the incidence of hyperammonemia (VAH) and hyperhomocysteinemia (HHcy) treated with different AEDs. And, based on the effect of epilepsy status on the cognitive function of patients, we also analyzed the effect of different AED treatments on children’s cognitive function. Our results show that sodium valproate, oxcarbazepine, and levetiracetam are all effective in the treatment of children with epilepsy and can be used as the first-line choice of antiepileptic treatment for children with epilepsy. However, compared with sodium valproate, levetiracetam and oxcarbazepine have a lower incidence of adverse drug reactions and do not cause an increase in blood ammonia and Hcy levels, so they have higher safety of drug treatment. In addition, compared with sodium valproate, levetiracetam and oxcarbazepine have better recovery of cognitive function in children with epilepsy and so they have better application value.

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Section: Introductionmentioning

confidence: 99%

Influence of Different Antiepileptic Drugs on Blood Ammonia and Homocysteine Levels in Children with Epilepsy

Sun

Zhou

Wang

et al. 2021

Evidence-Based Complementary and Alternative Medicine

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“…In this study, ECTS patients were treated with the secondgeneration AEDs, including OXC, LEV, VPA, and LTG. These new AEDs had very little side effects on cognition, and most of them could even protect processing speed ability [38][39][40][41][42][43]. The group comparison showed no significant differences in PSI among AED-naïve patients and patients who underwent monotherapy and polytherapy.…”

Section: Discussionmentioning

confidence: 94%

Processing speed dysfunction is associated with functional corticostriatal circuit alterations in childhood epilepsy with centrotemporal spikes: a PET and fMRI study

Zhang

Feng

et al. 2022

Eur J Nucl Med Mol Imaging

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Purpose Epilepsy with centrotemporal spikes (ECTS) is the most common epilepsy syndrome in children and usually presents with cognitive dysfunctions. However, little is known about the processing speed dysfunction and the associated neuroimaging mechanism in ECTS. This study aims to investigate the brain functional abnormality of processing speed dysfunction in ECTS patients by using the 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) and resting-state functional magnetic resonance imaging (rs-fMRI). Methods This prospective study recruited twenty-eight ECTS patients who underwent the 18F-FDG PET, rs-fMRI, and neuropsychological examinations. Twenty children with extracranial tumors were included as PET controls, and 20 healthy children were recruited as MRI controls. The PET image analysis investigated glucose metabolism by determining standardized uptake value ratio (SUVR). The MRI image analysis explored abnormal functional connectivity (FC) within the cortical–striatal circuit through network-based statistical (NBS) analysis. Correlation analysis was performed to explore the relationship between SUVR, FC, and processing speed index (PSI). Results Compared with healthy controls, ECTS patients showed normal intelligence quotient but significantly decreased PSI (P = 0.04). PET analysis showed significantly decreased SUVRs within bilateral caudate, putamen, pallidum, left NAc, right rostral middle frontal gyrus, and frontal pole of ECTS patients (P < 0.05). Rs-fMRI analysis showed absolute values of 20 FCs were significantly decreased in ECTS patients compared with MRI controls, which connected 16 distinct ROIs. The average SUVR of right caudate and the average of 20 FCs were positively correlated with PSI in ECTS patients (P = 0.034 and P = 0.005, respectively). Conclusion This study indicated that ECTS patients presented significantly reduced PSI, which is closely associated with decreased SUVR and FC of cortical–striatal circuit. Caudate played an important role in processing speed dysfunction. Clinical trial registration NCT04954729; registered on July 8, 2021, public site, https://clinicaltrials.gov/ct2/show/NCT04954729

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“…According to our eligibility criteria, 27 articles with 1737 participants were included in our systematic review. Of the 27 records included ( Mitsudome et al, 1997 ; Rating et al, 2000 ; Bast et al, 2003 ; Coppola et al, 2007 ; Kang et al, 2007 ; Andrade et al, 2009 ; Li SM et al, 2009 ; Li ZH and Huang, 2011 ; Zhou T, 2011 ; Gu HF, 2012 ; Tao and Wang, 2012 ; Borggraefe et al, 2013 ; Kwon et al, 2013 ; CH, 2014 ; Sun, 2015 ; Zhang J et al, 2015 ; Chen CY and Zheng, 2016 ; JY, 2016 ; Li J, 2016 ; Tacke et al, 2016 ; NS, 2017 ; Tacke, et al, 2018 ; Ahadi et al, 2020 ; Zhang et al, 2020 ; Du ZZ et al, 2021 ; LY, 2021 ; Suo et al, 2021 ), 19 studies involving 1,224 subjects were suitable for meta-analysis ( Mitsudome, et al, 1997 ; Rating, et al, 2000 ; Bast, et al, 2003 ; Coppola, et al, 2007 ; Li SM et al, 2009 ; Li ZH and Huang, 2011 ; Zhou T, 2011 ; Gu HF, 2012 ; Tao and Wang, 2012 ; Borggraefe, et al, 2013 ; CH, 2014 ; Sun, 2015 ; Chen CY and Zheng, 2016 ; JY, 2016 ; Li J, 2016 ; Tacke, et al, 2016 ; Ahadi, et al, 2020 ; Suo, et al, 2021 ; Zhang et al, 2020 ). A summary of the literature search according to the PRISMA flowchart is presented in Figure 1 .…”

Section: Resultsmentioning

confidence: 99%

“…Fifteen of these 27 studies were published in Chinese ( Mitsudome, et al, 1997 ; Rating, et al, 2000 ; Li SM et al, 2009 ; Li ZH and Huang, 2011 ; Zhou T, 2011 ; Gu HF, 2012 ; Tao and Wang, 2012 ; CH, 2014 ; Sun, 2015 ; Zhang J et al, 2015 ; Chen CY and Zheng, 2016 ; JY, 2016 ; Li J, 2016 ; NS, 2017 ; Zhang et al, 2020 ; Du ZZ et al, 2021 ; LY, 2021 ), 11 in English ( Bast, et al, 2003 ; Coppola, et al, 2007 ; Kang, et al, 2007 ; Borggraefe, et al, 2013 ; Kwon, et al, 2013 ; Tacke, et al, 2016 ; Tacke, et al, 2018 ; Ahadi, et al, 2020 ; Suo, et al, 2021 ), and one in Spanish ( Andrade, et al, 2009 ). Five studies compared the use of ASMs with placebo ( Rating, et al, 2000 ; Bast, et al, 2003 ; Kwon, et al, 2013 ; NS, 2017 ; LY, 2021 ), and the remaining 21 studies compared the efficacy of different ASMs ( Mitsudome, et al, 1997 ; Coppola, et al, 2007 ; Kang, et al, 2007 ; Andrade, et al, 2009 ; Li SM et al, 2009 ; Li ZH and Huang, 2011 ; Zhou T, 2011 ; Gu HF, 2012 ; Tao and Wang, 2012 ; Borggraefe, et al, 2013 ; CH, 2014 ; Zhang J et al, 2015 ; Sun, 2015 ; Chen CY and Zheng, 2016 ; Li J, 2016 ; JY, 2016 ; Tacke, et al, 2016 ; Tacke, et al, 2018 ; Ahadi, et al, 2020 ; Zhang et al, 2020 ; Du ZZ et al, 2021 ; Suo, et al, 2021 ). The eligible studies examined the effect of ASMs, including LEV, CBZ, STM, TPM, OXC, VPA, LTG, CLB, and CZP.…”

Section: Resultsmentioning

confidence: 99%

“…Ten studies ( Coppola, et al, 2007 ; Li ZH and Huang, 2011 ; Zhou T, 2011 ; Sun, 2015 ; Borggraefe, et al, 2013 ; JY, 2016 ; Tacke, et al, 2016 ; Ahadi, et al, 2020 ; Zhang et al, 2020 ; Suo, et al, 2021 ) including 589 subjects were included in the meta-analysis to investigate the proportion of patients who experienced any adverse events (total rate of ASMs) of antiepileptic drugs in the BECTS ( Figure 5 ). The pooled analysis results showed that the probability of experiencing any adverse events between LEV and OXC and VPA was not significantly different [RR = 0.57, 95% CI (0.19, 1.73); RR = 0.64, 95% CI (0.22, 1.81)], with moderate heterogeneity ( I 2 = 58.0%; I 2 = 66.9%).…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Anti-Seizure Medication Treatment of Benign Childhood Epilepsy With Centrotemporal Spikes: A Systematic Review and Meta-analysis

Wei¹,

Yang²,

Chen³

et al. 2022

Front. Pharmacol.

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Background: This study aimed to evaluate the efficacy and tolerability of Anti-Seizure medication (ASM) treatment in patients with BECTS.Method: We searched PubMed, Cochrane Library, Embase, MEDLINE, Web of Science, China National Knowledge Infrastructure (CNKI), WANFANG DATA, and China Science and Technology Journal Database (VIP) between 1 Jan 1990, and 1 Sep 2021, for randomized controlled studies. Data on seizure freedom rate, rate of treatment withdrawal due to serious adverse events, rate of any adverse events and dropout, 50% remission rate, the proportion of patients whose EEG to be normalized, and improvement in cognitive function were extracted by two authors independently. The pooled data were meta-analyzed using a random effects model.Results: A total of 27 studies evaluating 9 ASMs were included, 19 of which were suitable for meta-analysis. Compared with sulthiame (STM), levetiracetam (LEV) was associated with a higher probability of treatment withdrawal due to serious adverse events [RR = 5.12, 95% CI (1.19, 22.01), I2 = 0.0%], experiencing any adverse events [RR = 5.12, 95% CI (1.19, 22.01)], and dropping out for any reason [RR = 3.17, 95% CI (1.36, 10.11)], while it did not affect the seizure freedom rate [RR = 0.90, 95% CI (0.75, 1.06)]. LEV significantly improved cognitive performance relative to carbamazepine (CBZ) but had no effect on the proportion of any adverse events [RR = 0.62, 95% CI (0.25, 1.59)] and EEG to be normalized [RR = 1.27, 95% CI (0.94, 1.71)]. There was no higher probability of a 50% remission rate when comparing valproic acid (VPA) to LEV [RR = 0.96, 95% CI (0.57, 1.61)] and oxcarbazepine (OXC) [RR = 0.61, 95% CI (0.31, 1.20)]. In addition, STM was related to a higher probability of EEG normalization than placebo [RR = 4.61, 95% CI (2.12, 10.01)]. The included single studies also provided some evidence for the efficacy and/or tolerability of other ASMs in BECTS, including topiramate, lamotrigine, clobazam, and clonazepam. The risk of bias of the included studies was frequently low or unclear.Conclusion: This study indicated some discrepancies in efficacy and tolerability among ASMs used in patients with BECTS. More randomized controlled trials (RCTs) comparing ASMs with larger populations are required to ascertain the optimum antiepileptic drug treatment to guide clinicians.

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Effects of levetiracetam and oxcarbazepine monotherapy on intellectual and cognitive development in children with benign epilepsy with centrotemporal spikes

Cited by 8 publications

References 27 publications

Influence of Different Antiepileptic Drugs on Blood Ammonia and Homocysteine Levels in Children with Epilepsy

Influence of Different Antiepileptic Drugs on Blood Ammonia and Homocysteine Levels in Children with Epilepsy

Processing speed dysfunction is associated with functional corticostriatal circuit alterations in childhood epilepsy with centrotemporal spikes: a PET and fMRI study

Anti-Seizure Medication Treatment of Benign Childhood Epilepsy With Centrotemporal Spikes: A Systematic Review and Meta-analysis

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