Evidence mapPaperPMID 42237784Full record

Observational studyEpilepsia open2026

Perampanel as add-on in high-grade glioma-related epilepsy: Seizure control and QoL in a prospective, multicenter, real-world 6-month follow-up study.

Matteo Impellizzeri, Paolo Paone, Giada Pauletto, Annacarmen Nilo, Simone Beretta, Andrea Salmaggi, Stefano Consoli, Stefano Quadri

Abstract readMulticenter StudyObservational Study
In one paragraph

Observational study in Epilepsia open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0cells of the map it votes in
0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Matteo ImpellizzeriSC Neurology ASST Papa Giovanni XXIII, Bergamo, Italy.ORCID https://orcid.org/0000-0002-8861-5303
Paolo PaoneSC Neurology ASST Papa Giovanni XXIII, Bergamo, Italy.ORCID https://orcid.org/0000-0002-1505-746X
Giada PaulettoHead-Neck and Neurosciences Department, S. Maria Della Misericordia University Hospital, Udine, Italy.ORCID https://orcid.org/0000-0002-8875-6640
Annacarmen NiloHead-Neck and Neurosciences Department, S. Maria Della Misericordia University Hospital, Udine, Italy.ORCID https://orcid.org/0000-0001-9827-8059
Simone BerettaDepartment of Medicine and Surgery, University of Milano-Bicocca, Milano-Bicocca, Italy.ORCID https://orcid.org/0000-0002-9417-2748
Andrea SalmaggiNeurology Unit, Presidio A, Manzoni ASST, Lecco, Italy.ORCID https://orcid.org/0000-0001-6925-3434
Stefano ConsoliNeurology Unit, Presidio A, Manzoni ASST, Lecco, Italy.ORCID https://orcid.org/0000-0003-2523-4578
Stefano QuadriSC Neurology ASST Papa Giovanni XXIII, Bergamo, Italy.ORCID https://orcid.org/0000-0001-9696-6878

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveHigh-grade astrocytomas, including glioblastomas, are aggressive brain tumors with poor prognosis and a 5-year survival below 7%. Seizures affect up to 75% of glioma patients, especially in low-grade tumors but also in high-grade cases. Elevated extracellular glutamate in peritumoral tissue-due to tumor release, impaired uptake, and metabolic changes like D-2-hydroxyglutarate in IDH1-mutated tumors-contributes to neuronal hyperexcitability and tumor progression via AMPA and NMDA receptors' activation. Perampanel (PER), a selective noncompetitive AMPA receptor antagonist, targets this pathway, potentially reducing seizures and tumor growth. Clinical data on the use of perampanel in brain tumor-related epilepsy, particularly in patients with high-grade gliomas, are still limited.

methodsThis prospective multicenter observational study included 14 patients with brain tumor-related epilepsy (BTRE) from four Italian neuro-oncology centers. Patients received PER and were followed for 6 months. Seizure frequency, adverse events, quality of life (QoL), and survival were evaluated as real-world effectiveness outcomes.

resultsSeizure frequency decreased from 12.5 to 3 seizures/month at 6 months (p = 0.0023). Responder rate (≥50% seizure reduction) was 78.6%, with 57.1% seizure-free. Adverse events were mild; two patients discontinued PER treatment. QoL analyses showed improvement in communication and appetite even if not statistically significant. Survival analyses revealed no significant associations with clinical variables. Sensitivity analyses supported the consistency of results. SIGNIFICANCE: This real-world study suggests that PER may be effective and well tolerated in BTRE. While findings are exploratory, they provide useful clinical insight and highlight the need for larger studies to confirm efficacy, QoL effects, and the influence of molecular factors. PLAIN LANGUAGE SUMMARY: Patients with aggressive brain tumors often develop seizures that are difficult to control. In this study, perampanel reduced the number of seizures and did not worsen quality of life, being generally well tolerated. Patient survival was mainly determined by the tumor itself. Larger studies are needed to confirm the drug's effectiveness in reducing seizures, improving quality of life, evaluating survival, and monitoring side effects.

Indexed as

AnticonvulsantsBrain NeoplasmsEpilepsyGliomaNitrilesPyridonesQuality of LifeSeizuresAdultAgedFemaleFollow-Up StudiesHumansMaleMiddle AgedProspective StudiesAnticonvulsantsNitrilesperampanelPyridonesastrocytomaepilepsyglioblastomaPerampanelseizures

Identifiers

PMID42237784
PMCPMC13394621

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.