Anti-seizure medication tapering correlates with daytime delta band power reduction in the cortex
Anti-seizure medications (ASMs) are the primary treatment for epilepsy, yet medication tapering effects have not been investigated in a dose, region, and time-dependent manner, despite their potential impact on research and clinical practice. We examined over 3000 hours of intracranial EEG recording...
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Zusammenfassung: | Anti-seizure medications (ASMs) are the primary treatment for epilepsy, yet
medication tapering effects have not been investigated in a dose, region, and
time-dependent manner, despite their potential impact on research and clinical
practice.
We examined over 3000 hours of intracranial EEG recordings in 32 subjects
during long-term monitoring, of which 22 underwent concurrent ASM tapering. We
estimated ASM plasma levels based on known pharmaco-kinetics of all the major
ASM types.
We found an overall decrease in the power of delta band activity around the
period of maximum medication withdrawal in most (80%) subjects, independent of
their epilepsy type or medication combination. The degree of withdrawal
correlated positively with the magnitude of delta power decrease. This
dose-dependent effect was evident across all recorded cortical regions during
daytime; but not in sub-cortical regions, or during night time. We found no
evidence of a differential effect in seizure onset, spiking, or pathological
brain regions.
The finding of decreased delta band power during ASM tapering agrees with
previous literature. Our observed dose-dependent effect indicates that
monitoring ASM levels in cortical regions may be feasible for applications such
as medication reminder systems, or closed-loop ASM delivery systems. ASMs are
also used in other neurological and psychiatric conditions, making our findings
relevant to a general neuroscience and neurology audience. |
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DOI: | 10.48550/arxiv.2405.01385 |