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Anti-seizure medication tapering correlates with daytime delta band power reduction in the cortex

Title: Anti-seizure medication tapering correlates with daytime delta band power reduction in the cortex
Authors: Besne GM; Evans N; Panagiotopoulou M; Smith B; Chowdhury FA; Diehl B; Duncan JS; McEvoy AW; Miserocchi A; de Tisi J; Walker MC; Taylor PN; Thornton C; Wang Y
Source: Brain Communications, 2025
Publisher Information: Oxford University Press
Publication Year: 2025
Collection: Newcastle University Library ePrints Service
Description: © The Author(s) 2025. Published by Oxford University Press on behalf of the Guarantors of Brain. Anti-seizure medications are the primary treatment for epilepsy; yet medication tapering effects have not been investigated in a dose, region and time-dependent manner, despite their potential impact on research and clinical practice. We examined over 3000 h of intracranial EEG recordings in 32 subjects during long-term monitoring, of which 22 underwent concurrent anti-seizure medication tapering. We estimated anti-seizure medication plasma levels based on known pharmaco-kinetics of all the major anti-seizure medication types. We found an overall decrease in the power of delta band (δ) activity around the period of maximum medication withdrawal in most (80%) subjects, independent of their epilepsy type or medication combination. The degree of withdrawal correlated positively with the magnitude of δ power decrease. This dose-dependent effect was evident across all recorded cortical regions during daytime; but not in subcortical regions, or during night time. We found no evidence of a differential effect in seizure onset, spiking, or pathological brain regions. The finding of decreased δ band power during anti-seizure medication tapering agrees with previous literature. Our observed dose-dependent effect indicates that monitoring anti-seizure medication levels in cortical regions may be feasible for applications such as medication reminder systems, or closed-loop anti-seizure medication delivery systems. Anti-seizure medications are also used in other neurological and psychiatric conditions, making our findings relevant to a general neuroscience and neurology audience.
Document Type: article in journal/newspaper
File Description: application/pdf
Language: unknown
Relation: https://eprints.ncl.ac.uk/304936; https://eprints.ncl.ac.uk/fulltext.aspx?url=304936/F2C6CC39-0DE2-4CD2-95DA-E30BF051020E.pdf&pub_id=304936
Availability: https://eprints.ncl.ac.uk/304936
Rights: https://creativecommons.org/licenses/by/4.0/
Accession Number: edsbas.D0DB67EE
Database: BASE