Levetiracetam

[Petr75]

2020 Jun 17
Rehabilitation Unit, "Mons. L. Novarese" Hospital, Moncrivello, Vercelli, Italy
Efficacy of Levetiracetam on Upper Limb Movement in Multiple Sclerosis Patients With Cerebellar Signs: A Multicenter Double-Blind, Placebo-Controlled, Crossover Study
https://pubmed.ncbi.nlm.nih.gov/32558044/

Abstract

Background: The literature provides contrasting results on the efficacy of levetiracetam (LEV) in multiple sclerosis (MS) patients with cerebellar signs. We sought to evaluate the efficacy of LEV on upper limb movement in MS patients.

Methods: In this multicenter double-blind placebo-controlled crossover study, MS patients with prevalently cerebellar signs were randomly allocated into two groups: LEV followed by placebo (Group 1) or placebo followed by LEV (Group 2). Clinical assessments were performed by a blinded physician at T0 (day 1), T1 (day 22), T2 (2-week wash-out period, day 35), and T3 (day 56). The primary outcome was dexterity in the arm with greater deficit, assessed by the nine-hole peg test (9HPT). Secondary clinical outcomes included responders on the 9HPT (∆9HPT>20%), tremor activity of daily living questionnaire and self-defined upper limb impairment, through a numeric rating scale. Kinematic evaluation was performed using a digitizing tablet, providing data on normalized jerk (NJ), aiming error and centripetal acceleration.

Results: Forty-eight subjects (45.2±10.4 years) were randomly allocated into two groups (n=24 each). 9HPT significantly improved in the LEV phase in both groups (p<0.001). The LEV treatment phase lead to a significant improvement (p<0.01) of all clinical outcomes in Group 1 and in dexterity in Group 2. No significant changes were reported during both placebo phases in both groups. Considering the kinematic analysis, only NJ significantly improved after treatment with LEV (T0-T1) in Group 1.

Conclusions: LEV treatment seems to be effective in improving upper limb dexterity in MS patients with cerebellar signs.