Neuropsychiatric Disease and Treatment (Aug 2017)
Levetiracetam is associated with decrease in subclinical epileptiform discharges and improved cognitive functions in pediatric patients with autism spectrum disorder
Abstract
Minjian Wang,1–4 Li Jiang,2–5 Xiaoju Tang5 1Department of Psychology, 2Ministry of Education Key Laboratory of Child Development and Disorders, 3Key Laboratory of Pediatrics in Chongqing, 4Chongqing International Science and Technology Cooperation Center for Child Development and Disorders, 5Department of Neurology, Children’s Hospital of Chongqing Medical University, Chongqing, People’s Republic of China Objective: Subclinical epileptiform discharges (SEDs) are common in pediatric patients with autism spectrum disorder (ASD), but the effect of antiepileptic drugs on SEDs in ASD remains inconclusive. This physician-blinded, prospective, randomized controlled trial investigated an association between the anticonvulsant drug levetiracetam and SEDs in children with ASD. Methods: A total of 70 children with ASD (4–6 years) and SEDs identified by electroencephalogram were randomly divided into two equal groups to receive either levetiracetam and educational training (treatment group) or educational training only (control). At baseline and after 6 months treatment, the following scales were used to assess each individual’s behavioral and cognitive functions: the Chinese version of the Psychoeducational Profile – third edition (PEP-3), Childhood Autism Rating Scale (CARS), and Autism Behavior Checklist (ABC). A 24-hour electroencephalogram was recorded on admission (baseline) and at follow-up. The degree of satisfaction of each patient was also evaluated. Results: Relative to baseline, at the 6-month follow-up, the PEP-3, CARS, and ABC scores were significantly improved in both the treatment and control groups. At the 6-month follow-up, the PEP-3 scores of the treatment group were significantly higher than those of the control, whereas the CARS and ABC scores were significantly lower, and the rate of electroencephalographic normalization was significantly higher in the treatment group. Conclusion: Levetiracetam appears to be effective for controlling SEDs in pediatric patients with ASD and was also associated with improved behavioral and cognitive functions. Keywords: autism spectrum disorder, subclinical epileptiform discharges, levetiracetam, behavioral function, cognitive function, randomized controlled trial
