海马硬化在癫痫患者托吡酯相关抑郁和认知缺陷中的作用。
The role of hippocampal sclerosis in topiramate-related depression and cognitive deficits in people with epilepsy.
作者信息
Mula Marco, Trimble Michael R, Sander Josemir W A S
机构信息
Department of Clinical & Experimental Epilepsy, Institute of Neurology, University College London, Queen Square, London, England, UK.
出版信息
Epilepsia. 2003 Dec;44(12):1573-7. doi: 10.1111/j.0013-9580.2003.19103.x.
PURPOSE
To clarify the role of hippocampal sclerosis (HS) in developing psychiatric and cognitive adverse events during therapy with topiramate (TPM) in patients with temporal lobe epilepsy (TLE).
METHODS
We analyzed the data of 70 patients with TLE and HS and 128 patients with cryptogenic TLE matched for age, sex, starting dose, and titration schedule of TPM. They were selected from the first consecutive 431 patients started on TPM between 1995 and 1999.
RESULTS
Patients with HS were more likely to develop cognitive adverse events (CAEs; p = 0.002) and depression (p = 0.018) and to be receiving a polytherapy regimen (p = 0.007). However, regression analysis demonstrated that only HS was a predictive factor for the occurrence of CAEs (OR = 2.4; p < 0.001) and depression (OR = 2.3; p = 0.02).
CONCLUSIONS
Patients with TLE and HS were more prone to develop CAEs and depression than were patients with cryptogenic TLE, during TPM therapy, despite the same titration schedule. The presence of HS and not duration of epilepsy or polytherapy regimen represented the main risk factor.
目的
阐明海马硬化（HS）在颞叶癫痫（TLE）患者使用托吡酯（TPM）治疗期间发生精神和认知不良事件中的作用。
方法
我们分析了70例TLE合并HS患者以及128例年龄、性别、起始剂量和TPM滴定方案相匹配的隐源性TLE患者的数据。他们选自1995年至1999年间开始使用TPM的首批连续431例患者。
结果
HS患者更易发生认知不良事件（CAEs；p = 0.002）和抑郁（p = 0.018），且更常接受联合治疗方案（p = 0.007）。然而，回归分析表明，只有HS是CAEs发生（OR = 2.4；p < 0.001）和抑郁（OR = 2.3；p = 0.02）的预测因素。
结论
在TPM治疗期间，尽管滴定方案相同，但TLE合并HS的患者比隐源性TLE患者更容易发生CAEs和抑郁。HS的存在而非癫痫持续时间或联合治疗方案是主要危险因素。
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