Quantitative EEG effects of carbamazepine, oxcarbazepine, valproate, lamotrigine, and possible clinical relevance of the findings.
Quantitative EEG (QEEG) effects of therapeutic doses of carbamazepine (CBZ), oxcarbazepine (OXC), valproate (VA) and lamotrigine (LA) monotherapy were investigated in patients with beginning epilepsy. Baseline waking EEG (EEG1) was recorded in the untreated state, the second EEG (EEG2) was done after 8 weeks of reaching the therapeutic dose. Left occipital data were used for analysis. QEEG target parameters were absolute band-power (delta: AD, theta: AT, alpha: AA, beta: AB), and alpha mean frequency (AMF). Group effects (untreated versus treated condition in the CBZ, VA, OXC, LA groups) were computed for each target parameter. One group with benign rolandic epilepsy remained untreated for clinical reasons and served to estimate the QEEG test-retest differences. In addition, the individual QEEG response to each drug was calculated as (EEG2-EEG1).


RESULTS
statistically significant (p<0.05) group differences indicated the QEEG domain systematically affected by the drugs. CBZ caused AT increase and AMF decrease. OXC caused AMF decrease. VA and LA did not decrease AMF (LA even increased it), but reduced broad-band power. Individual power and AMF changes showed considerable variability in each group. >0.5 Hz AMF decrease (that was reported to predict cognitive impairment in prior studies) occurred in 10/41 patients in the CBZ group but never in the OXC, VA, LA groups. The results may be utilized in planning further studies addressing the relationship between antiepileptic drugs and their CNS effects. In addition, the relationship of AED-related cognitive impairment and AMF changes was discussed.
Clemens
Béla
B
Kenézy Gyula Memorial Hospital, Department of Neurology, Epilepsy Center, Bartók Béla út 3, 4031 Debrecen, Hungary. clemensdr@freemail.hu
Ménes
Andrea
A
Piros
Pálma
P
Bessenyei
Mónika
M
Altmann
Anna
A
Jerney
Judit
J
Kollár
Katalin
K
Rosdy
Beáta
B
Rózsavölgyi
Margit
M
Steinecker
Katalin
K
Hollódy
Katalin
K
D000293:Adolescent; D000328:Adult; D000513:Alpha Rhythm / Q000187:drug effects; D000927:Anticonvulsants / Q000494:pharmacology* / Q000627:therapeutic use; D002220:Carbamazepine / Q000031:analogs & derivatives / Q000494:pharmacology / Q000627:therapeutic use; D002648:Child; D004569:Electroencephalography / Q000187:drug effects*; D004827:Epilepsy / Q000188:drug therapy / Q000503:physiopathology*; D005260:Female; D006801:Humans; D000077213:Lamotrigine; D008297:Male; D009778:Occipital Lobe / Q000187:drug effects*; D014227:Triazines / Q000494:pharmacology / Q000627:therapeutic use; D014635:Valproic Acid / Q000494:pharmacology / Q000627:therapeutic use
D000927:Anticonvulsants; D014227:Triazines; C476610:oxcarbamazepine; D002220:Carbamazepine; D014635:Valproic Acid; D000077213:Lamotrigine