Effect of Levetiracetam on Cognition in Patients With Alzheimer Disease With and Without Epileptiform Activity

左乙拉西坦 斯特罗普效应 临床痴呆评级 认知 癫痫 随机对照试验 医学 交叉研究 安慰剂 痴呆 心理学 听力学 物理疗法 精神科 疾病 内科学 认知障碍 替代医学 病理
作者
Keith Vossel,Kamalini G. Ranasinghe,Alexander J. Beagle,Alice La,Kasey Ah Pook,Madelyn Castro,Danielle Mizuiri,Susanne Honma,Nisha Venkateswaran,Mary Koestler,Wenbo Zhang,Lennart Mucke,Michael J. Howell,Katherine L. Possin,Joel H. Kramer,Adam L. Boxer,Bruce L. Miller,Srikantan S. Nagarajan,Heidi E. Kirsch
出处
期刊:JAMA Neurology [American Medical Association]
卷期号:78 (11): 1345-1345 被引量:184
标识
DOI:10.1001/jamaneurol.2021.3310
摘要

Network hyperexcitability may contribute to cognitive dysfunction in patients with Alzheimer disease (AD).To determine the ability of the antiseizure drug levetiracetam to improve cognition in persons with AD.The Levetiracetam for Alzheimer's Disease-Associated Network Hyperexcitability (LEV-AD) study was a phase 2a randomized double-blinded placebo-controlled crossover clinical trial of 34 adults with AD that was conducted at the University of California, San Francisco, and the University of Minnesota, Twin Cities, between October 16, 2014, and July 21, 2020. Participants were adults 80 years and younger who had a Mini-Mental State Examination score of 18 points or higher and/or a Clinical Dementia Rating score of less than 2 points. Screening included overnight video electroencephalography and a 1-hour resting magnetoencephalography examination.Group A received placebo twice daily for 4 weeks followed by a 4-week washout period, then oral levetiracetam, 125 mg, twice daily for 4 weeks. Group B received treatment using the reverse sequence.The primary outcome was the ability of levetiracetam treatment to improve executive function (measured by the National Institutes of Health Executive Abilities: Measures and Instruments for Neurobehavioral Evaluation and Research [NIH-EXAMINER] composite score). Secondary outcomes were cognition (measured by the Stroop Color and Word Test [Stroop] interference naming subscale and the Alzheimer's Disease Assessment Scale-Cognitive Subscale) and disability. Exploratory outcomes included performance on a virtual route learning test and scores on cognitive and functional tests among participants with epileptiform activity.Of 54 adults assessed for eligibility, 11 did not meet study criteria, and 9 declined to participate. A total of 34 adults (21 women [61.8%]; mean [SD] age, 62.3 [7.7] years) with AD were enrolled and randomized (17 participants to group A and 17 participants to group B). Thirteen participants (38.2%) were categorized as having epileptiform activity. In total, 28 participants (82.4%) completed the study, 10 of whom (35.7%) had epileptiform activity. Overall, treatment with levetiracetam did not change NIH-EXAMINER composite scores (mean difference vs placebo, 0.07 points; 95% CI, -0.18 to 0.32 points; P = .55) or secondary measures. However, among participants with epileptiform activity, levetiracetam treatment improved performance on the Stroop interference naming subscale (net improvement vs placebo, 7.4 points; 95% CI, 0.2-14.7 points; P = .046) and the virtual route learning test (t = 2.36; Cohen f2 = 0.11; P = .02). There were no treatment discontinuations because of adverse events.In this randomized clinical trial, levetiracetam was well tolerated and, although it did not improve the primary outcome, in prespecified analysis, levetiracetam improved performance on spatial memory and executive function tasks in patients with AD and epileptiform activity. These exploratory findings warrant further assessment of antiseizure approaches in AD.ClinicalTrials.gov Identifier: NCT02002819.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
陈昊完成签到,获得积分10
5秒前
6秒前
tian发布了新的文献求助10
8秒前
11秒前
11秒前
龙舞星完成签到,获得积分10
12秒前
13秒前
王涉发布了新的文献求助10
15秒前
普鲁卡因发布了新的文献求助10
16秒前
量子星尘发布了新的文献求助10
18秒前
柚子完成签到,获得积分10
22秒前
23秒前
马儿饿了要吃草完成签到,获得积分10
23秒前
25秒前
sudor123456完成签到,获得积分10
30秒前
NXK发布了新的文献求助10
30秒前
打打应助普鲁卡因采纳,获得10
33秒前
35秒前
lii完成签到,获得积分10
35秒前
jiaolulu发布了新的文献求助10
41秒前
个性惜蕊完成签到,获得积分10
41秒前
44秒前
轩辕书白完成签到,获得积分10
45秒前
qinzhikai完成签到,获得积分10
49秒前
天真的冬瓜完成签到,获得积分10
50秒前
小溜溜完成签到 ,获得积分10
51秒前
普鲁卡因发布了新的文献求助10
52秒前
tian发布了新的文献求助10
53秒前
桃花源的瓶起子完成签到 ,获得积分10
57秒前
平凡世界完成签到 ,获得积分10
58秒前
YYLLTX完成签到,获得积分10
59秒前
畅快山兰完成签到 ,获得积分10
59秒前
gaoxiaogao完成签到,获得积分10
59秒前
舒适怀寒完成签到 ,获得积分10
59秒前
shenglll完成签到 ,获得积分10
1分钟前
量子星尘发布了新的文献求助10
1分钟前
普鲁卡因发布了新的文献求助10
1分钟前
Liang完成签到,获得积分10
1分钟前
爱思考的小笨笨完成签到,获得积分10
1分钟前
123456完成签到 ,获得积分10
1分钟前
高分求助中
【提示信息,请勿应助】关于scihub 10000
Les Mantodea de Guyane: Insecta, Polyneoptera [The Mantids of French Guiana] 3000
徐淮辽南地区新元古代叠层石及生物地层 3000
The Mother of All Tableaux: Order, Equivalence, and Geometry in the Large-scale Structure of Optimality Theory 3000
Handbook of Industrial Diamonds.Vol2 1100
Global Eyelash Assessment scale (GEA) 1000
Picture Books with Same-sex Parented Families: Unintentional Censorship 550
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 4038112
求助须知:如何正确求助?哪些是违规求助? 3575788
关于积分的说明 11373801
捐赠科研通 3305604
什么是DOI,文献DOI怎么找? 1819255
邀请新用户注册赠送积分活动 892655
科研通“疑难数据库(出版商)”最低求助积分说明 815022