To evaluate short course levetiracetam therapy by Beck Depression Index (BDI) and neurotoxicity scale scores in a cohort of brain tumor patients, sorted by tumor location.

We evaluated rates of depression & neurotoxic symptoms by tumor location in post resection brain tumor patients treated for 1 week vs 6 weeks of prophylactic levetiracetam.  The overall study goal was to determine optimal post-surgical therapy and minimize negative side effects. 

Higher neurotoxicity (9 vs –3, p=0.0420)  and BDI (4 vs. 0, p= 0.0086) scores were seen with bifrontal tumors vs. other locations, regardless of treatment arm.  Seizure incidence was rare, with 1 patient in each treatment arm (2.9% of total patients) experiencing a seizure during the follow-up period.

Nine patients treated with immediate release levetiracetam due to XR levetiracetam access issues tended to have increased BDI and neurotoxicity scores, but this did not reach significance (P=0.0821).  

Fatigue, slowing & memory difficulties were the predominant symptoms reported in any tumor location subgroup. No difference in BDI or neurotoxicity score was shown by treatment duration, race, or sex.

Increased BDI and neurotoxicity scores observed in post-resection patients with bifrontal tumors on levetiracetam raises concern for optimal postoperative recovery prior to neuro-oncologic therapy but could be confounded by co-administration of high dose corticosteroids and poor prognosis.

Regardless, increased vigilance & intervention in these patients may improve recovery, quality of life and reduce adverse effects of therapy. Future research is warranted to separate the effect of therapy from clinicopathological factors.