Epilepsy in patients with primary brain tumors: The impact on mood, cognition, and HRQOL

Rahman, Zebunnessa; Wong, Chong; Dexter, Mark; Olsson, Gunnar; Wong, Myo; Gebsky, V.; Nahar, Nurun; Wood, Amanda G.; King, Madeleine; Bleasel, Andrew

doi:10.1016/j.yebeh.2015.03.016

Cited by 35 publications

(18 citation statements)

References 44 publications

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“…Overall, 52 patients were treated with LEV (Table 1). TE-PAEs occurred in 14 and the tumor was located in the frontal lobe, left (8) or right (6), in all these patients. In the remaining 38 patients without TE-PAEs, tumor location was in the left (16) or right (7) The total daily LEV dose was 2071.43+319.44 mg (mean+SD) in the first group and 2065.79+307.17 mg in the second group respectively, given in 2 daily administrations in both groups; a paired t test did not show any statistically significant difference.…”

Section: Statistical Datamentioning

confidence: 84%

“…Noteworthy, epilepsy is an independent risk factor for poor quality of life in patients with brain tumors mainly as a consequence of the frequent occurrence of adverse events of antiepileptic drugs (AEDs) and/or the possible poor control of seizures [5]. A recent study suggests that patients with brain tumors and 'well-controlled epilepsy' have a comparable health-related quality of life (HRQOL) to that of subjects without epilepsy [6]. Management of seizures associated with brain tumors requires consideration of different aspects, including: i) high rate of recurrence after a first seizure; ii) increased sensitivity to the adverse effects of AEDs; iii) changes in clinical response in relation to the disease progression; iv) possible occurrence of disadvantageous interactions between AEDs and anticancer agents [7].…”

Section: Introductionmentioning

confidence: 99%

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Brain tumor location influences the onset of acute psychiatric adverse events of levetiracetam therapy: an observational study

Belcastro

Pisani²,

Bellocchi

et al. 2017

J Neurol

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To explore possible correlations among brain lesion location, development of psychiatric symptoms and the use of antiepileptic drugs (AEDs) in a population of patients with brain tumor and epilepsy. The medical records of 283 patients with various types of brain tumor (161 M/122 F, mean age 64.9 years) were analysed retrospectively. Patients with grade III and IV glioma, previous history of epileptic seizures and/or psychiatric disorders were excluded. Psychiatric symptoms occurring after initiation of AED therapy were considered as treatment emergent psychiatric adverse events (TE-PAEs) if they fulfilled the following conditions: (1) onset within 4 weeks after the beginning of AED therapy; (2) disappearance on drug discontinuation; (3) absence of any other identified possible concurrent cause. The possible influence of the following variables were analysed: (a) AED drug and dose; (b) location and neuroradiologic features of the tumor, (c) location and type of EEG epileptic abnormalities, (d) tumor excision already or not yet performed; (e) initiation or not of radiotherapy. TE-PAEs occurred in 27 of the 175 AED-treated patients (15.4%). Multivariate analysis showed a significant association of TE-PAEs occurrence with location of the tumor in the frontal lobe (Odds ratio: 5.56; 95% confidence interval 1.95-15.82; p value: 0.005) and treatment with levetiracetam (Odds ratio: 3.61; 95% confidence interval 1.48-8.2; p value: 0.001). Drug-unrelated acute psychiatric symptoms were observed in 4 of the 108 AED-untreated patients (3.7%) and in 7 of the 175 AED-treated patients (4%). The results of the present study suggest that an AED alternative to levetiracetam should be chosen to treat epileptic seizures in patients with a brain tumor located in the frontal lobe to minimize the possible onset of TE-PAEs.

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Section: Statistical Datamentioning

confidence: 84%

Section: Introductionmentioning

confidence: 99%

Brain tumor location influences the onset of acute psychiatric adverse events of levetiracetam therapy: an observational study

Belcastro

Pisani²,

Bellocchi

et al. 2017

J Neurol

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“…The average percentage of men in the total sample was 51.3%. 17 studies assessed for depression or depressive symptoms using Hospital Anxiety and Depression Scale (HADS-D) [ 4 , 7 , 13 , 14 , 21 , 33 , 35 , 39 – 43 , 45 , 46 , 49 – 51 ], 6 used Beck Depression Inventory (BDI) [ 5 , 6 , 23 , 44 , 52 , 54 , 57 ], 2 used the Zung Self-Rating Depression Scale (Zung SDS) [ 51 , 58 ], 2 used Diagnostic and Statistical Manual of Mental Disorders, 4th. Edition (DSM-IV) [ 12 , 47 ], 10 used other methods [ 19 , 20 , 22 , 24 , 34 , 36 , 37 , 48 , 53 , 56 ].…”

Section: Resultsmentioning

confidence: 99%

Association between depression and brain tumor: a systematic review and meta-analysis

et al. 2017

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BackgroundPatients with brain tumor are in risk of depression or depressive symptoms, but the estimated prevalence varies between studies. The aim of this study is to get a proper summarized estimate of depression prevalence in brain tumor patients.MethodsLiterature search on Pubmed, PsycINFO, and Cochrane library from January 1981 through October 2016. The prevalence of depression or depressive symptoms in brain tumor patients was estimated by screening scales and analyzed using stratified meta-analysis and subgroup analysis. The prevalence of depression level or symptoms during the follow-up periods was detected by secondary analysis.ResultsAmong the 37 studies included in this meta-analysis, 25 used a cross-sectional design and 12 used longitudinal study. The pooled prevalence was 21.7% (971/4518 individuals, 95 % confidence interval (CI) 18.2%–25.2%) for overall sample. Lower prevalence was detected in studies with sample size ≥100 than <100, lower grade tumor than high grade tumor, studies using clinician-rated depression scales than self-rated or non-depression-specific ones, and in patients from UK, Germany and Italy than USA. After analyzing 6 longitudinal studies, prevalence of depression remained no change in the follow-up periods. No significant differences were observed between study designs and tumor types.ConclusionsThe estimated prevalence of depression or depressive symptoms among brain tumor patients was 21.7%, affected by depression assessment type, sample size, tumor grade and country. Diagnosis and treatment of co-morbid depression in brain tumor patients need to be addressed in future studies for better life quality and oncology management.

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“…The regulatory documents only mention that special attention should be paid to central nervous system adverse effects of antiepileptic drugs, but specific requirements are not set up 1,2 . Many validated scales for measurement of potential central adverse effects of antiepileptic drugs (with excellent psychometric properties) are now available for precise measurement of anxiety, depression, cognition, and quality of life in general 25,26 . Such instruments should be stated in the regulatory acts, at least as examples, in order to stimulate their use in practice.…”

Section: Safety Issuesmentioning

confidence: 99%

Improving clinical drug development regulatory procedures for anticonvulsants

Janković¹,

Ilić²

2015

Racion ter

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Background: Clinical development of antiepileptic drugs is demanding due to complex character of the disorder and to diversity of its forms and etiologies.Objective: The aim of this review was to suggest improvements in regulatory procedures for clinical development of antiepileptic drugs.Methods: The following databases of scientific articles were searched: MEDLINE, SCO-PUS and SCINDEKS. In total 558 publications were retrieved. The types of articles selected were reviews, reports on clinical trials and letters to the Editor.Results: There are several changes of regulatory documents necessary for improving process of clinical development of antiepileptic drugs: preference of parallel groups design for add-on trials should be explicit; the noninferiority design for monotherapy clinical trials should be acceptable; restrictive formulations when trials of antiepileptic drugs in children are in question should be avoided; requirements in regard to the efficacy measures should be harmonized among the regulatory bodies; proactive attitude towards discovery of adverse events; and precise requirements for clinical trials specifi-

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Epilepsy in patients with primary brain tumors: The impact on mood, cognition, and HRQOL

Cited by 35 publications

References 44 publications

Brain tumor location influences the onset of acute psychiatric adverse events of levetiracetam therapy: an observational study

Brain tumor location influences the onset of acute psychiatric adverse events of levetiracetam therapy: an observational study

Association between depression and brain tumor: a systematic review and meta-analysis

Improving clinical drug development regulatory procedures for anticonvulsants

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