Quantitative Effects of Cannabidiol Administration on the EEG in Refractory Epilepsy
Abstract number :
3.104
Submission category :
2. Translational Research / 2C. Biomarkers
Year :
2021
Submission ID :
1825505
Source :
www.aesnet.org
Presentation date :
12/6/2021 12:00:00 PM
Published date :
Nov 22, 2021, 06:44 AM
Authors :
Caren Armstrong, MD, PhD - Children's Hospital of Philadelphia; Patrick Mulcahey, BS - University of Pennsylvania; Alexis Zavez - University of Pennsylvania; Eric Marsh, MD PhD - neurology - Children's Hospital of Philadelphia
Rationale: Pharmaceutical grade cannabidiol (CBD) is one of the newest anti-seizure medications for refractory epilepsy. Many medications have notable effects on the electroencephalogram (EEG), but the effects of CBD on the EEG have not yet been described. Quantitative EEG analysis could not only reveal changes that occur with CBD, but also allow for the development of an EEG biomarker to predict a patient’s response to CBD without a lengthy medication trial.
Methods: With EEG obtained prior to and 12 weeks after initiation of CBD in refractory epilepsy patients enrolled in the CBD expanded access study, we utilized MATLAB to generate a nonbiased quantitative analysis of background EEG to determine whether there are consistent changes seen in the EEG with administration of CBD. In addition, we examined whether any EEG features at baseline or in the first post-CBD EEG were significantly different in patients who responded with seizure reduction to CBD compared with nonresponders.
Results: With the addition of CBD, there were no significant changes in EEG amplitude, standard deviation of the amplitude, skewness, or kurtosis. There were also no changes in relative delta, theta, or alpha power. However, there was an increase in relative beta power seen with addition of CBD, particularly in the temporal region. In addition, a measure of noise known as 1/f slope was less negative with the addition of CBD. Changes in beta and 1/f slope with the addition of CBD were seen in responders, but not in non-responders.
Conclusions: The addition of CBD to existing medication regimens in patients with refractory epilepsy does induce increases in relative beta activity and changes in 1/f slope (a measurement of noise). This is helpful for clinicians to know when reading the EEG of patients on CBD. In addition, changes in EEG from baseline differ in responders as compared with nonresponders to CBD. The latter finding suggests that further analysis of additional EEG features may allow for the development of a biomarker to help the clinician predict a patient’s clinical response to CBD administration after a brief medication trial, and warrants further study.
Funding: Please list any funding that was received in support of this abstract.: PA state tobacco fund grant (to EM), CHOP epilepsy fellowship (to CA).
Translational Research