Evidence map›Paper›PMID 31168673›Full record

ArticleJournal of neurology2019

Synaptic vesicle protein 2A tumoral expression predicts levetiracetam adverse events.

Michele Romoli, Martina Mandarano, Marina Romozzi, Paolo Eusebi, Chiara Bedetti, Elena Nardi Cesarini, Angela Verzina, Carmen Calvello, Elisabetta Loreti, Angelo Sidoni and 3 more

Abstract readMulticenter Study
PubMed Publisher
In one paragraph

Article in Journal of neurology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
0.5field-weighted citation impact, top 35% of its field
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

5 citing papers in PubMed, 1 synthesis or guideline pooled it, 5 citations in OpenAlex.

  1. Neuropsychiatric Adverse Effects Associated with the Use of Levetiracetam in Adults: A Systematic Review and Meta-Analysis.Medical principles and practice : international journal of the Kuwait University, Health Science Centre · 2026
    Pooled it
  2. Article
  3. Review
  4. Review
  5. Review
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

13 authors at 3 institutions in 1 country.

Michele RomoliNeurology Clinic, University of Perugia, S. Maria Della Misericordia Hospital, Piazzale G. Menghini 1, Perugia, Italy.
Martina MandaranoDepartment of Experimental Medicine, Section of Anatomic Pathology and Histology, University of Perugia, Perugia, Italy.
Marina RomozziNeurology Clinic, University of Perugia, S. Maria Della Misericordia Hospital, Piazzale G. Menghini 1, Perugia, Italy.
Paolo EusebiNeurology Clinic, University of Perugia, S. Maria Della Misericordia Hospital, Piazzale G. Menghini 1, Perugia, Italy.
Chiara BedettiNeurology Clinic, University of Perugia, S. Maria Della Misericordia Hospital, Piazzale G. Menghini 1, Perugia, Italy.
Elena Nardi CesariniNeurology Clinic, University of Perugia, S. Maria Della Misericordia Hospital, Piazzale G. Menghini 1, Perugia, Italy.
Angela VerzinaNeurology Clinic, University of Perugia, S. Maria Della Misericordia Hospital, Piazzale G. Menghini 1, Perugia, Italy.
Carmen CalvelloNeurology Clinic, University of Perugia, S. Maria Della Misericordia Hospital, Piazzale G. Menghini 1, Perugia, Italy.
Elisabetta LoretiDepartment of Experimental Medicine, Section of Anatomic Pathology and Histology, University of Perugia, Perugia, Italy.
Angelo SidoniDepartment of Experimental Medicine, Section of Anatomic Pathology and Histology, University of Perugia, Perugia, Italy.
Paolo GiovenaliDiagnostic Cytology and Histology Unit, S. Maria Della Misericordia Hospital, Perugia, Italy.
Paolo CalabresiNeurology Clinic, University of Perugia, S. Maria Della Misericordia Hospital, Piazzale G. Menghini 1, Perugia, Italy.
Cinzia CostaNeurology Clinic, University of Perugia, S. Maria Della Misericordia Hospital, Piazzale G. Menghini 1, Perugia, Italy. cinzia.costa@unipg.it.
University of Perugia · ITAzienda Ospedaliera di Perugia · ITIstituti di Ricovero e Cura a Carattere Scientifico · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThe efficacy of levetiracetam (LEV) in controlling seizures in patients with brain tumor-related epilepsy (BTRE) depends on tumoral expression of synaptic vesicle protein 2A (SV2A). Although LEV is generally well tolerated, neuropsychiatric adverse events (NPAEs) might occur, limiting compliance and seizure control. We aimed to assess the influence of tumoral SV2A expression on the occurrence of LEV-related NPAEs in patients with glioma.

methodsSpecimens from patients enrolled in the multicenter COMPO study, with glioma and BTRE treated with LEV, undergoing neurosurgery were retrieved. Immunohistochemistry-based expression of SV2A in tumoral and peritumoral tissue was scored in a four-point scale from absent (score = 0) to strong (score = 3). Low immunoreactivity (IR) corresponded to scores < 2. Staining ratios (tumoral SV2A IR/peritumoral SV2A IR) were grouped into low (≤ 0.5) and high (> 0.5). NPAEs were assessed longitudinally with the Neuropsychiatry Inventory 12 test (NPI-12).

resultsOverall, 18 patients were eligible for analysis. All received LEV monotherapy, with 67% developing NPAEs. Patients with NPAEs had significantly lower median SV2A intensity score compared to patients without NPAEs (score 1 vs 0, p = 0.025). Low staining ratio (≤ 0.5) associated with higher NPAE occurrence compared to SR > 0.5 (85.7% vs 0%, p < 0.01). A SR ≤ 0.5 predicted a consistent increase in risk of NPAEs (OR 45.0; 95% CI 1.8-1128; p = 0.02).

conclusionsOur results suggest that SV2A expression in tumoral and peritumoral tissue correlates with the occurrence of LEV-related NPAEs. Thus, considering that SV2A expression also influences LEV effectiveness, SV2A staining might help in tailoring treatment to patients.

Indexed as

AdultAgedAnticonvulsantsBiomarkersBrain NeoplasmsEpilepsyFemaleGene ExpressionHumansLevetiracetamMaleMembrane GlycoproteinsMental DisordersMiddle AgedNerve Tissue ProteinsPredictive Value of TestsAnticonvulsantsBiomarkersLevetiracetamMembrane GlycoproteinsNerve Tissue ProteinsSV2A protein, humanAdverse eventsAntiepileptic drugsBrain tumorEpilepsyGlioma

Identifiers

PMID31168673
OpenAlexW2948130825

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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 OpenQuestion graph.