To Investigate The Effect Of Perampanel Monotherapy On Sleep And Cognition In Patients With Epilepsy

Objective:To observe the effects of perampanel,the third generation anti-seizure medication,on sleep and cognition in patients with epilepsy,and provide new medication guidance for patients with epilepsy who comorbid sleep disorder.Methods:This prospective study collected newly diagnosed patients with focal epilepsy who visited the First Hospital of Shanxi University of from November 2021 to November2022.The initial dose of perampanel was 2 mg/night,and the treatment dose was 4-8mg/night.The treatment dose was maintained for at least 3 months.Before and after treatment,each patient underwent polysomnography and video-electroencephalography(PSG-VEEG)monitoring.Pittsburgh Sleep Quality Index(PSQI),Insomnia Severity Scale(ISI),Epworth Sleepiness Scale(ESS),anxiety and depression scale(GAD-7,PHQ-9),and Montreal Cognitive Assessment Scale(Mo CA)were also completed.Finally,we compared changes before and after medication.Results:Of the 36 patients included in the study,thirty-three patients completed scale assessments twice and 18 patients completed PSG-VEEG monitoring twice.1.Objective sleep indicators in patients with epilepsy were improved after perampanel monotherapy,with a significant improvement in total sleep time,sleep efficiency,sleep maintenance efficiency,and the proportion of N3 phase(P<0.05).And the waking time after sleep onset were significantly reduced(P<0.05).2.After treatment with perampanel monotherapy,PSQI scores of epilepsy patients were significantly decreased(P<0.05),and the proportion of patients with decreased sleep quality was significantly decreased(P<0.05).ESS and ISI scores were significantly decreased(P<0.05),but the proportion of patients with insomnia and daytime sleepiness after medication had no statistical significance(P>0.05).3.Perampanel monotherapy had no significant effect on anxiety and depression(P>0.05).4.Perampanel monotherapy significantly increased Mo CA score in patients with epilepsy(P<0.05).Conclusion:Perampanel monotherapy can improve the sleep structure and sleep quality of patients with epilepsy,and significantly reduce ESS and ISI scores,which may be a new medication choice for patients with epilepsy complicated with sleep disorders.At the same time,perampanel had no significant effect on anxiety and depression in patients with epilepsy.And perampanel may have potential value for cognitive improvement.