Abstracts

Cenobamate Modulates EEG Microstates Enhancing Epilepsy Network in Patients with Drug-resistant Temporal Lobe Epilepsy

Abstract number : 3.426
Submission category : 7. Anti-seizure Medications / 7E. Other
Year : 2024
Submission ID : 578
Source : www.aesnet.org
Presentation date : 12/9/2024 12:00:00 AM
Published date :

Authors :
Pierpaolo Croce, PhD – Department of Neurosciences, Imaging and Clinical Sciences
Rita Agosto, MD – University “G. D’Annunzio” of Chieti-Pescara
Sara Cipollone, MD – Department of Neuroscience, Imaging and Clinical Science, “G. D'Annunzio” University of Chieti-Pescara, Chieti, Italy
Paolo Quintieri, MD – Department of Neuroscience, Imaging and Clinical Science, “G. D'Annunzio” University of Chieti-Pescara, Chieti, Italy
Giacomo Evangelista, MD, cPhD – Department of Neuroscience, Imaging and Clinical Science, “G. D'Annunzio” University of Chieti-Pescara, Chieti, Italy
Stefano Consoli, MD – Department of Neuroscience Imaging and Clinical Sciences "G. d’Annunzio” University of Chieti-Pescara
Clarissa Corniello, MD – Department of Neuroscience Imaging and Clinical Sciences "G. d’Annunzio” University of Chieti-Pescara
Sibilla De Angelis, MD – University “G. D’Annunzio” of Chieti-Pescara
Fedele Dono, MD, MSc, cPHD, FEBN – Deparment of Neuroscience, Imaging and Clinical Sciences, "G. d'Annunzio" University of Chieti-Pescara
Stefano Sensi, MD, PhD – 'G. D'Annunzio' University of Chieti Pescara
Presenting Author: Davide Liviello, MD – Department of Neuroscience, Imaging and Clinical Science, “G. D'Annunzio” University of Chieti-Pescara, Chieti, Italy


Rationale: Cenobamate (CNB) is an antiseizure medication developed for the treatment of focal-onset seizures in adult patients. EEG microstates are defined as global patterns of scalp potential topographies that dynamically vary over time in an organized manner. Four classical EEG microstates (i.e., A, B, C, and D) are described. This study investigated whether CNB impacts already-known microstate patterns.


Methods: Twenty-one patients with pharmacoresistant temporal lobe epilepsy (TLE) were selected for this study. Sixteen cases had a structural etiology, while the remaining five had an unknown etiology. All participants experienced a reduction in seizure frequency; however, the response rate varied from less than 50% reduction to complete seizure freedom. Each patient received a standard therapeutic dose of 200 mg of CNB. We conducted a resting-state microstate EEG analysis to compare metrics between EEGs performed at baseline (EEGpre) and after six months of CNB treatment (EEGpost). We analyzed the mean duration, frequency of occurrence, coverage, and directional predominance of the four traditional microstate templates (A, B, C, and D) using TANOVA analysis.


Results: CNB treatment resulted in several changes in the patients' microstate dynamics. Specifically, we observed a reduction in both the mean duration and the occurrence per second of microstates B and D. Conversely, there was an increase in the mean duration and occurrence per second of microstates A and C. Additionally, CNB treatment led to an increased directional predominance from microstate A to B and from microstate A to D. These changes suggest that CNB alters the focal TLE networks, with reduced influence on the activity of resting-state global cortical networks.


Conclusions: The observed alterations suggest that CNB exerts its antiseizure effects, leading to a reorganization of cortical activity patterns. These findings support the hypothesis that CNB modifies functional network dynamics in the brain, potentially contributing to its therapeutic effects in reducing seizures. CNB treatment induces significant changes in the metrics and dynamics of EEG microstates in patients with pharmaco-resistant TLE. This study highlights the utility of EEG microstate analysis as a tool for understanding the impact of antiseizure medications on brain dynamics.


Funding: No fundings

Anti-seizure Medications