Lampl C, Buzath A, Klinger D, Neumann K
Department of Neurology, General Hospital Linz, Austria.
Cephalalgia. 1999 Jan;19(1):58-63. doi: 10.1111/j.1468-2982.1999.1901058.x.
The aim of this study was to evaluate the efficacy of lamotrigine, a glutamate antagonist blocking voltage-sensitive sodium channels, in the prophylaxis of migraine aura symptoms. Glutamate is one of the main neurotransmitters involved in the development of cortical spreading depression. The study was conducted as an open longitudinal trial over 7 months, with a treatment phase of 4 months and a post-treatment period of 3 months. Thirteen patients suffering from migraine with aura and 2 patients with aura but without migraine were enrolled and treated with lamotrigine. The dose was gradually increased in steps of 25 mg up to 100 mg per day, depending on the patient's aura symptoms. Aura symptoms were reduced from baseline (an average of 1.3 aura episodes per month) to month 4 (0.1, p < 0.001). High statistical significance was also observed with regard to aura duration (23 min at baseline vs 4 min at 4 months, p < 0.001). In all 15 cases, increases in aura frequency (on average sevenfold, p < 0.001) and aura duration (minutes; on average more than threefold, p < 0.001) were evident following cessation of treatment. A number of mild to moderate adverse events without any medical consequences occurred. The study outcome suggests that lamotrigine is effective in preventing migraine aura symptoms and in influencing migraine headache frequency.
本研究旨在评估拉莫三嗪（一种阻断电压敏感性钠通道的谷氨酸拮抗剂）预防偏头痛先兆症状的疗效。谷氨酸是参与皮层扩散性抑制发生的主要神经递质之一。该研究作为一项为期7个月的开放性纵向试验进行，治疗阶段为4个月，治疗后阶段为3个月。招募了13名患有先兆偏头痛的患者和2名有先兆但无偏头痛的患者，用拉莫三嗪进行治疗。根据患者的先兆症状，剂量以25毫克的步长逐渐增加至每日100毫克。先兆症状从基线水平（平均每月1.3次先兆发作）降至第4个月时（0.1次，p<0.001）。在先兆持续时间方面也观察到高度统计学显著性（基线时为23分钟，4个月时为4分钟，p<0.001）。在所有15例病例中，停药后先兆频率（平均增加七倍，p<0.001）和先兆持续时间（分钟；平均增加超过三倍，p<0.001）均明显增加。发生了一些无任何医学后果的轻度至中度不良事件。研究结果表明，拉莫三嗪在预防偏头痛先兆症状和影响偏头痛发作频率方面有效。
