TY - JOUR
T1 - Electroencephalographic changes in purified pharmaceutical cannabidiol therapy
AU - Herlopian, Aline
AU - Barnett, James R.
AU - Nascimento, Fábio A.
AU - Lee, Hang
AU - Thiele, Elizabeth A.
N1 - Funding Information:
The authors of this paper would like to thank the patients and their families for cooperating in the study and allowing their data to be used. We would also like to thank GW Pharmaceuticals for providing the study drug at no cost to the participants.
Publisher Copyright:
© 2022
PY - 2022/3
Y1 - 2022/3
N2 - Objective: Evaluate electroencephalographic changes in patients receiving purified pharmaceutical cannabidiol (CBD). Methods: A total of 104 EEG studies from 52 patients with pediatric-onset refractory epilepsy, who were enrolled in the FDA-approved expanded access investigational new drug program, were retrospectively analyzed for electroencephalographic changes in the background, interictal epileptiform discharges (IEDs), ictal findings, and sleep architecture after CBD treatment. Results: Patients were between 18 months and 52 years of age. After CBD treatment, 88.4% (46/52) of patients had EEG changes. Eighty-nine percent of these patients had changes in their background, 74% in IEDs, 46% in ictal findings, and 17% in sleep architecture. Seven out of 52 patients had modified hypsarrhythmia on their pre-treatment EEG. The pattern resolved in 2/7 patients (29%), diminished in prevalence in 4/7 (57%) subjects, and remained unchanged in 1/7 (14%) cases. Electrographic improvement was seen in 70% (32/46) of the patients, and worsening in 7% (3/46) of the cases. At the post-CBD EEG, 83% had a reduction in the frequency of the most predominant seizure type, and 25% reported subjective cognitive improvement. Of these patients, 88% (p = 0.09) and 92% (p = 0.45) had corresponding EEG changes, respectively. Conclusion: Our results revealed electrographic changes in association with the CBD treatment. Despite these changes, a substantial association between specific electrographic findings and clinical outcomes was not established.
AB - Objective: Evaluate electroencephalographic changes in patients receiving purified pharmaceutical cannabidiol (CBD). Methods: A total of 104 EEG studies from 52 patients with pediatric-onset refractory epilepsy, who were enrolled in the FDA-approved expanded access investigational new drug program, were retrospectively analyzed for electroencephalographic changes in the background, interictal epileptiform discharges (IEDs), ictal findings, and sleep architecture after CBD treatment. Results: Patients were between 18 months and 52 years of age. After CBD treatment, 88.4% (46/52) of patients had EEG changes. Eighty-nine percent of these patients had changes in their background, 74% in IEDs, 46% in ictal findings, and 17% in sleep architecture. Seven out of 52 patients had modified hypsarrhythmia on their pre-treatment EEG. The pattern resolved in 2/7 patients (29%), diminished in prevalence in 4/7 (57%) subjects, and remained unchanged in 1/7 (14%) cases. Electrographic improvement was seen in 70% (32/46) of the patients, and worsening in 7% (3/46) of the cases. At the post-CBD EEG, 83% had a reduction in the frequency of the most predominant seizure type, and 25% reported subjective cognitive improvement. Of these patients, 88% (p = 0.09) and 92% (p = 0.45) had corresponding EEG changes, respectively. Conclusion: Our results revealed electrographic changes in association with the CBD treatment. Despite these changes, a substantial association between specific electrographic findings and clinical outcomes was not established.
KW - Electroencephalography
KW - Hypsarrhythmia
KW - Medication refractory epilepsy
KW - Purified pharmaceutical cannabidiol
KW - Seizure reduction
UR - http://www.scopus.com/inward/record.url?scp=85123185432&partnerID=8YFLogxK
U2 - 10.1016/j.yebeh.2022.108558
DO - 10.1016/j.yebeh.2022.108558
M3 - Article
C2 - 35078115
AN - SCOPUS:85123185432
SN - 1525-5050
VL - 128
JO - Epilepsy and Behavior
JF - Epilepsy and Behavior
M1 - 108558
ER -