QPEEG analysis of the effects of sodium valproate on adult Chinese patients with generalized tonic-clonic seizures

Abstract

Objectives EEG effects of the sustained-release form of sodium valproate (SR-VPA) are unknown, although it is widely used in Chinese patients with generalized tonicclonic seizures (GTCS). Methods Fourteen newly diagnosed, untreated GTCS patients were recruited and treated with SR-VPA. Waking EEG was recorded and analyzed by way of quantitative pharmaco-electroencephalogram (QPEEG) analysis during the three-month follow-up. Results There was a statistically significant decrease in the absolute power of the delta band (P < 0.05), theta band (P < 0.03) and partial alpha-1 band (p < 0.05) with treatment compared to before treatment, while there was no significantly different absolute power between one-month and three-months after treatment. There was a strong correlation between the decrease in absolute power and the degree of the initial abnormality in all frequency bands. Two of 14 patients experienced seizures during the second month after initiation of SR-VPA therapy. Conclusions SR-VPA selectively decreased the activity of the abnormal EEG synchronization in a use-dependent manner. The reduced theta, delta, and partial alpha-1 absolute power may reflect or confirm the efficacy of SR-VPA on patients with GTCS.

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

“…Both δ and θ band power significantly decreased in the treated group compared to both control groups 100 . This finding was also found in another low‐risk‐of‐bias study 77 (Tables 12 and 13). One moderate‐risk‐of‐bias study investigated change in band power following the initiation of cannabidiol 40 in subjects with drug‐resistant childhood onset epilepsy.…”

“…After IED, spectral power had the most low–moderate‐risk‐of‐bias evidence to support its use as a biomarker, with consistent reports from low‐risk‐of‐bias studies that effective ASM causes a reduction in δ and θ band power 76,77,100 . This result would benefit from investigation in continuous longitudinal EEG studies with >1 year follow‐up, to evaluate long‐term seizure outcomes.…”

“…After IED, spectral power had the most low-moderate-risk-of-bias evidence to support its use as a biomarker, with consistent reports from lowrisk-of-bias studies that effective ASM causes a reduction in δ and θ band power. 76,77,100 This result would benefit from investigation in continuous longitudinal EEG studies with >1 year follow-up, to evaluate long-term seizure outcomes. Ultralong EEG studies would assist in determining whether changes in power are due to effective medication, or due to natural daily, monthly, or yearly fluctuations, which have been observed in studies by Viana et al 61 and Rosadini and Sannita.…”

“…T B E 1 3 Summary of results of spectral power and frequency changes from spectral power analysis, following an ASM change unless otherwise stated. 77 Initiation VPA modified-release monotherapy ↓ in δ (0-3.9 Hz), θ (4-7.9 Hz), and α-1 (8-9.9 Hz) absolute power; no change in α (8-12.9 Hz) mean frequency or % of total band power Supports (L) Clemens (2008) 75 Initiation VPA monotherapy However, generalizability is a problem for the models identified in this review. 18,19,146,147 For example, Braathen Melander applied the Medical Research Council's to their own cohort and it could not predict outcomes.…”

“…There were no obvious qualitative trends to suggest one biomarker should be used in a specific age group (Figure 6). Moreover, it was common for researchers 38,[49][50][51]57,63,[65][66][67][68][69][70][71][72][73][74][75][76][77][78][79][80][81][82][83][84] to combine age groups in their analysis. Results were likely confounded when infants, children, and adults were analyzed together.…”