Levetiracetam Modulates EEG Microstates in Temporal Lobe Epilepsy

Ricci, Lorenzo; Croce, Pierpaolo; Pulitano, Patrizia; Boscarino, Marilisa; Zappasodi, Filippo; Narducci, Flavia; Lanzone, Jacopo; Sancetta, Biagio; Mecarelli, Oriano; Lazzaro, Vincenzo Di; Tombini, Mario; Assenza, Giovanni

doi:10.1007/s10548-022-00911-2

Cited by 19 publications

(9 citation statements)

References 51 publications

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“…Figure 1 displays the number of biomarkers within each class and category and associated overall risk‐of‐bias rating (domain risk‐of‐bias ratings are in Table S2). A 15th category, Microstates, was identified but excluded from this review as the study 39 was undergoing peer review. Detailed Concept results will be discussed after Population and Context search results.…”

Section: Resultsmentioning

confidence: 99%

Prognostic interictal electroencephalographic biomarkers and models to assess antiseizure medication efficacy for clinical practice: A scoping review

et al. 2023

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Antiseizure medication (ASM) is the primary treatment for epilepsy. In clinical practice, methods to assess ASM efficacy (predict seizure freedom or seizure reduction), during any phase of the drug treatment lifecycle, are limited. This scoping review identifies and appraises prognostic electroencephalographic (EEG) biomarkers and prognostic models that use EEG features, which are associated with seizure outcomes following ASM initiation, dose adjustment, or withdrawal. We also aim to summarize the population and context in which these biomarkers and models were identified and described, to understand how they could be used in clinical practice. Between January 2021 and October 2022, four databases, references, and citations were systematically searched for ASM studies investigating changes to interictal EEG or prognostic models using EEG features and seizure outcomes. Study bias was appraised using modified Quality in Prognosis Studies criteria. Results were synthesized into a qualitative review. Of 875 studies identified, 93 were included. Biomarkers identified were classed as qualitative (visually identified by wave morphology) or quantitative. Qualitative biomarkers include identifying hypsarrhythmia, centrotemporal spikes, interictal epileptiform discharges (IED), classifying the EEG as normal/abnormal/epileptiform, and photoparoxysmal response. Quantitative biomarkers were statistics applied to IED, high‐frequency activity, frequency band power, current source density estimates, pairwise statistical interdependence between EEG channels, and measures of complexity. Prognostic models using EEG features were Cox proportional hazards models and machine learning models. There is promise that some quantitative EEG biomarkers could be used to assess ASM efficacy, but further research is required. There is insufficient evidence to conclude any specific biomarker can be used for a particular population or context to prognosticate ASM efficacy. We identified a potential battery of prognostic EEG biomarkers, which could be combined with prognostic models to assess ASM efficacy. However, many confounders need to be addressed for translation into clinical practice.

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Section: Resultsmentioning

confidence: 99%

Prognostic interictal electroencephalographic biomarkers and models to assess antiseizure medication efficacy for clinical practice: A scoping review

et al. 2023

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“…Interestingly, a previous study conducted in patients with temporal lobe epilepsy has shown that levetiracetam induces a reduction in Microstate B duration and occurrence. 41 Since levetiracetam is extremely efficacious in suppressing PPR 42 , 43 and considering our findings, it could be argued that the changes of Microstate B induced by levetiracetam might reflect the inhibition of the hyper-excitability of the visual system. If confirmed, Microstate B temporal metrics could therefore potentially serve as biomarkers to assess the efficacy of ASMs on PS.…”

Section: Discussionmentioning

confidence: 63%

Resting-state electroencephalography microstates as a marker of photosensitivity in juvenile myoclonic epilepsy

Mazzeo,

Cerulli Irelli,

Leodori

et al. 2024

Brain Communications

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Juvenile myoclonic epilepsy is an idiopathic generalized epilepsy syndrome associated with photosensitivity in approximately 30-40% of cases. Microstates consist in brief period of times during which the topography of the whole resting-state EEG signal is characterized by a specific configuration. Previous neurophysiological and neuroimaging studies have suggested that microstate B may represent activity within the visual network. In this case-control study, we aimed to investigate whether anatomical and functional alterations in the visual network observed in individuals with PS could lead to changes in microstate B dynamics in photosensitive patients with juvenile myoclonic epilepsy. Resting-state EEG microstate analysis was performed on twenty-eight patients with juvenile myoclonic epilepsy. Of these, fifteen patients exhibited photosensitivity, while the remaining thirteen served as non-photosensitive controls. The two groups were carefully matched in terms of age, sex, seizure control, and anti-seizure medications. Multivariate ANOVA and repeated-measures ANOVA were performed to assess significant differences in microstates metrics and syntax between the photosensitive and the non-photosensitive group. Post-hoc false discovery rate adjusted unpaired t-tests were used to determine differences in specific microstates classes between the two groups. The four classical microstates (class A, B, C, D) accounted for 72.8% of the total EEG signal variance in the photosensitive group and 75.64% in the non-photosensitive group. Multivariate ANOVA revealed a statistically significant class*group interaction on microstates temporal metrics (p = 0.021). False discovery rate adjusted univariate ANOVAs indicated a significant class*group interaction for both mean occurrence (p = 0.002) and coverage (p = 0.03), but not for mean duration (p = 0.14). Post-hoc, false discovery rate adjusted unpaired T-tests showed significantly higher coverage (p = 0.02) and occurrence (p = 0.04) of microstate class B in photosensitive patients compared with non-photosensitive participants, along with an increased probability of transitioning from microstates C (p = 0.04) and D (p = 0.02) to microstate B. No significant differences were found concerning the other microstate classes between the two groups. Our study provides novel insights on resting-state EEG microstates dynamics underlying photosensitivity in patients with juvenile myoclonic epilepsy. The increased representation of microstate B in these patients might reflect the resting state overactivation of the visual system underlying photosensitivity. Further research is warranted to investigate microstate dynamics in other photosensitive epilepsy syndromes.

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“…Finally, the parameters of the microstate (i.e., duration, occurrence, contribution, and transition probability) were calculated. Duration indicates that each microstate maintains a stable average time length when it appears; occurrence represents the number of times each microstate appears per second; contribution describes the proportion of the total time of each microstate; and transition probability indicates the probability of converting from one microstate to another ( Croce et al, 2020 ; Ricci et al, 2022 ).

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Section: Methodsmentioning

confidence: 99%

The effect of acupuncture at the Taiyang acupoint on visual function and EEG microstates in myopia

Su,

Wang,

Wang

et al. 2023

Front. Integr. Neurosci.

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ObjectiveAcupuncture has certain effects to improve myopia visual function, but its neural mechanism is unclear. In this study, we acupunctured at the right Taiyang acupoint of myopic patients to analyze the effects of acupuncture on visual function and electroencephalographic activity and to investigate the correlation between improvements in visual function and changes in the brain.MethodsIn this study, a total of 21 myopic patients were recruited. The contrast sensitivity (CS) of the subjects was examined before and after acupuncture, and electroencephalography (EEG) data of the entire acupuncture process were recorded.ResultsThe study found that compared with before acupuncture, the CS of both eyes in myopic patients at each spatial frequency was increased after acupuncture; compared with the resting state, the contribution of microstate C was decreased during the post-acupuncture state, and the transition probability between microstate A and microstate C was reduced; in addition, the contribution of microstate C was negatively correlated with CS at both 12 and 18 cpd.ConclusionThe contrast sensitivity of myopic patients was improved after acupuncture at the Taiyang acupoint (20 min), which may be related to microstate C.

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Levetiracetam Modulates EEG Microstates in Temporal Lobe Epilepsy

Cited by 19 publications

References 51 publications

Prognostic interictal electroencephalographic biomarkers and models to assess antiseizure medication efficacy for clinical practice: A scoping review

Prognostic interictal electroencephalographic biomarkers and models to assess antiseizure medication efficacy for clinical practice: A scoping review

Resting-state electroencephalography microstates as a marker of photosensitivity in juvenile myoclonic epilepsy

The effect of acupuncture at the Taiyang acupoint on visual function and EEG microstates in myopia

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