{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T16:50:35Z","timestamp":1785775835620,"version":"3.56.0"},"reference-count":35,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T00:00:00Z","timestamp":1780531200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T00:00:00Z","timestamp":1780531200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epilepsia Open"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>High\u2010grade astrocytomas, including glioblastomas, are aggressive brain tumors with poor prognosis and a 5\u2010year survival below 7%. Seizures affect up to 75% of glioma patients, especially in low\u2010grade tumors but also in high\u2010grade cases. Elevated extracellular glutamate in peritumoral tissue\u2014due to tumor release, impaired uptake, and metabolic changes like D\u20102\u2010hydroxyglutarate in IDH1\u2010mutated tumors\u2014contributes 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\u2010related epilepsy, particularly in patients with high\u2010grade gliomas, are still limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This prospective multicenter observational study included 14 patients with brain tumor\u2010related epilepsy (BTRE) from four Italian neuro\u2010oncology centers. Patients received PER and were followed for 6 months. Seizure frequency, adverse events, quality of life (QoL), and survival were evaluated as real\u2010world effectiveness outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Seizure frequency decreased from 12.5 to 3 seizures\/month at 6 months (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0023). Responder rate (\u226550% seizure reduction) was 78.6%, with 57.1% seizure\u2010free. 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.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Significance<\/jats:title>\n                    <jats:p>This real\u2010world 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Plain Language Summary<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/epi4.70274","type":"journal-article","created":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T07:52:38Z","timestamp":1780559558000},"page":"1137-1148","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Perampanel as add\u2010on in high\u2010grade glioma\u2013related epilepsy: Seizure control and\n                    <scp>QoL<\/scp>\n                    in a prospective, multicenter, real\u2010world 6\u2010month follow\u2010up study"],"prefix":"10.1002","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8861-5303","authenticated-orcid":false,"given":"Matteo","family":"Impellizzeri","sequence":"first","affiliation":[{"name":"SC Neurology ASST Papa Giovanni XXIII  Bergamo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1505-746X","authenticated-orcid":false,"given":"Paolo","family":"Paone","sequence":"additional","affiliation":[{"name":"SC Neurology ASST Papa Giovanni XXIII  Bergamo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8875-6640","authenticated-orcid":false,"given":"Giada","family":"Pauletto","sequence":"additional","affiliation":[{"name":"Head\u2010Neck and Neurosciences Department S. Maria Della Misericordia University Hospital  Udine Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9827-8059","authenticated-orcid":false,"given":"Annacarmen","family":"Nilo","sequence":"additional","affiliation":[{"name":"Head\u2010Neck and Neurosciences Department S. Maria Della Misericordia University Hospital  Udine Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9417-2748","authenticated-orcid":false,"given":"Simone","family":"Beretta","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery University of Milano\u2010Bicocca  Milano\u2010Bicocca Italy"},{"name":"Department of Neurology Fondazione IRCCS San Gerardo Dei Tintori  Monza Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6925-3434","authenticated-orcid":false,"given":"Andrea","family":"Salmaggi","sequence":"additional","affiliation":[{"name":"Neurology Unit, Presidio A, Manzoni ASST  Lecco Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2523-4578","authenticated-orcid":false,"given":"Stefano","family":"Consoli","sequence":"additional","affiliation":[{"name":"Neurology Unit, Presidio A, Manzoni ASST  Lecco Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9696-6878","authenticated-orcid":false,"given":"Stefano","family":"Quadri","sequence":"additional","affiliation":[{"name":"SC Neurology ASST Papa Giovanni XXIII  Bergamo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,4]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/neuonc\/noaf177"},{"key":"e_1_2_14_3_1","doi-asserted-by":"crossref","unstructured":"PrakashO LukiwWJ PeruzziF ReissK MustoAE.Gliomas and seizures. 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