Anti-seizure medication tapering correlates with daytime delta band power reduction in the cortex
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arXiv
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| Format: | Preprint |
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2024
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| author | Besne, Guillermo M. Evans, Nathan Panagiotopoulou, Mariella Smith, Billy Chowdhury, Fahmida A Diehl, Beate Duncan, John S McEvoy, Andrew W Miserocchi, Anna de Tisi, Jane Walker, Mathew Taylor, Peter N. Thornton, Chris Wang, Yujiang |
| author_facet | Besne, Guillermo M. Evans, Nathan Panagiotopoulou, Mariella Smith, Billy Chowdhury, Fahmida A Diehl, Beate Duncan, John S McEvoy, Andrew W Miserocchi, Anna de Tisi, Jane Walker, Mathew Taylor, Peter N. Thornton, Chris Wang, Yujiang |
| contents | 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. |
| format | Preprint |
| id |
arxiv_https___arxiv_org_abs_2405_01385 |
| institution | arXiv |
| publishDate | 2024 |
| record_format | arxiv |
| spellingShingle | Anti-seizure medication tapering correlates with daytime delta band power reduction in the cortex Besne, Guillermo M. Evans, Nathan Panagiotopoulou, Mariella Smith, Billy Chowdhury, Fahmida A Diehl, Beate Duncan, John S McEvoy, Andrew W Miserocchi, Anna de Tisi, Jane Walker, Mathew Taylor, Peter N. Thornton, Chris Wang, Yujiang Neurons and Cognition 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. |
| title | Anti-seizure medication tapering correlates with daytime delta band power reduction in the cortex |
| topic | Neurons and Cognition |
| url | https://arxiv.org/abs/2405.01385 |