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Perampanel effect on sleep architecture in patients with epilepsy.

Perampanel 对癫痫患者睡眠结构的影响。

  • 影响因子:2.77
  • DOI:10.1016/j.seizure.2020.01.021
  • 作者列表:"Rocamora R","Álvarez I","Chavarría B","Principe A
  • 发表时间:2020-02-10
Abstract

PURPOSE:Among patients with epilepsy, sleep disturbances can worsen seizure control. This prospective open-label study determined the effect of the antiepileptic drug perampanel on sleep architecture in patients with refractory epilepsy. METHODS:Adult patients with refractory epilepsy received add-on perampanel, starting at 2 mg/day at bedtime, increased by 2 mg after 2 weeks and then monthly until the target dose of 4-8 mg/day was reached. The median dose of perampanel used was 6 mg (SD 1.2). Polysomnographic (PSG) recordings were scheduled 1 week before starting perampanel and the control PSG after 12 weeks under perampanel treatment and at least 4 weeks on stable perampanel dose; patients completed the Epworth Sleepiness Scale (ESS) and Pittsburgh Sleep Quality Index (PSQI) questionnaires. The main endpoints were change from baseline in the ESS and PSQI scores, and PSG variables. RESULTS:Of 25 patients included (aged 18-65 years, 56 % female) only 17 completed the study. Perampanel caused a modest decrease from baseline in mean ESS score (n = 13 patients; p = 0.126) and PSQI score (n = 12 patients; p = 0.127). Treatment significantly improved sleep parameters (n = 17 patients) including total sleep time (p = 0.037), sleep latency (p = 0.022), sleep efficiency (p = 0.015), sleep maintenance index (p = 0.005), wake time after sleep onset (p = 0.015), and duration of N3 sleep stage (p = 0.026). Patients with altered sleep efficiency parameters at baseline showed a significant increase in sleep maintenance index (p = 0.015), and 77.8 % achieved sleep efficiency >85 % (p = 0.016 vs baseline). CONCLUSION:Perampanel improved sleep architecture in patients with focal refractory epilepsy without worsening daytime sleepiness.

摘要

目的: 在癫痫患者中,睡眠障碍可使癫痫发作控制恶化。这项前瞻性开放标签研究确定了抗癫痫药物 perampanel 对难治性癫痫患者睡眠结构的影响。 方法: 成人难治性癫痫患者接受添加 perampanel,睡前开始 2 mg/天, 2 周后增加 2 mg,然后每月增加,直到达到 4-8 mg/天的目标剂量。使用 perampanel 的中位剂量为 6 mg (SD 1.2)。在开始 perampanel 前 1 周安排多导睡眠图 (PSG) 记录,在 perampanel 治疗下 12 周后安排对照 PSG,在稳定 perampanel 剂量下至少 4 周; 患者完成 Epworth 嗜睡量表 (ESS) 和匹兹堡睡眠质量指数 (PSQI) 问卷。主要终点是 ESS 和 PSQI 评分与基线相比的变化,以及 PSG 变量。 结果: 在纳入的 25 例患者 (年龄 18-65 岁,56% 为女性) 中,只有 17 例完成了研究。Perampanel 导致平均 ESS 评分 (n = 13 例患者; p = 0.126) 和 PSQI 评分 (n = 12 例患者; p = 0.127) 较基线略有下降。治疗显著改善了 17 例患者的睡眠参数,包括总睡眠时间 (p = 0.037) 、睡眠潜伏期 (p = 0.022), 睡眠效率 (p = 0.015) 、睡眠维持指数 (p = 0.005) 、睡眠后觉醒时间 (p = 0.015) 、和 N3 睡眠阶段的持续时间 (p = 0.026)。基线时睡眠效率参数改变的患者睡眠维持指数显著增加 (p = 0.015),77.8% 的患者达到睡眠效率> 85% (p = 0.016 vs 基线)。 结论: Perampanel 改善了局灶性难治性癫痫患者的睡眠结构,无白天嗜睡恶化。

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影响因子:4.30
发表时间:2020-01-24
来源期刊:Experimental neurology
DOI:10.1016/j.expneurol.2020.113212
作者列表:["Bertrand SJ","Zhang Z","Patel R","O'Ferrell C","Punjabi NM","Kudchadkar SR","Kannan S"]

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影响因子:1.52
发表时间:2020-01-27
来源期刊:World neurosurgery
DOI:10.1016/j.wneu.2020.01.108
作者列表:["Middlebrooks EH","Lin C","Okromelidze L","Lu CQ","Tatum WO","Wharen RE Jr","Grewal SS"]

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