Abstracts

Rationale: The anti-epileptic effect and drug safety of the levetiracetam (LEV) has been well documented. However, there are few clinical studies that are investigated for the predictability of response to LEV, especially in the early stage of drug trial. The aim of this study is to find the clinical parameters for predicting the good response to levetiracetam in focal epilepsy patients.Methods: Twelve epilepsy patients were included. All participants had never been taken levetiracetam before. Before and after levetiracetam administration (1 month after), FDG-PET, QOLIE-31 and EEG were performed respectively in all subjects. We divided the participants by drug response (good vs poor). The good response group (7 subjects) was defined that the frequency of seizure decrease more than 50% of baseline period (during 3months before LEV intake) and the other five were defined poor response group. After 1-month LEV trial, we performed a comparison between two response group about the variations of brain glucose metabolism (FDG-PET), power spectrum of EEG and QOLIE-31.Results: In good response group, we find the increase of glucose metabolism in bilateral caudate, both frontal, and left parietal regions (uncorrected p<0.005). However, in poor response group, there are no significant variations of glucose metabolism. Also, in good response group, we find the changes of EEG spectrum by spectral analysis of EEG. Delta (1-3Hz) power of EEG is decrease in parietal region (p<0.05) and beta-1 (13-19Hz) power is increased in frontal region (p<0.05). But we can t find any significant EEG changes in poor response group. There are no significant changes of QOLIE-31 in both groups.Conclusions: Our result suggests that the initial drug response to LEV may be discriminated according to the change of LEV-induced glucose metabolism and EEG spectral power, as early as only one-month after medication start. It might be used as a predictive marker of anti-epileptic effect of LEV. Further studies with larger sample size should be warranted.