Smith Michael E, Gevins Alan, McEvoy Linda K, Meador Kimford J, Ray Patricia G, Gilliam Frank
San Francisco Brain Research Institute and SAM Technology, San Francisco, California 94108, USA.
Epilepsia. 2006 Apr;47(4):695-703. doi: 10.1111/j.1528-1167.2006.00508.x.
To contrast the effects of lamotrigine (LTG) and topiramate (TPM) on cognitive task-related and resting-state EEG and evoked potential (EP) measures.
We used a double-blind, randomized, crossover design. Healthy adults (N = 29) had two 8-week periods of dose escalation, 4 weeks of drug maintenance (300 mg daily), and 4 weeks of washout. EEG was recorded during working memory (WM) tasks and resting conditions at baseline, at the end of each maintenance phase, and after final washout. RESULTS. LTG did not affect overt performance on the tasks, although it reduced EEG power in both resting and WM task conditions, most prominently in the 6- to 12-Hz frequency range, and attenuated P300 evoked-potential amplitude equally in both WM task loads. TPM slowed responses and increased errors. It also increased EEG power below 6 Hz in all conditions, and reduced the amplitude of a slow wave observed in a difficult version of the WM task.
The drugs produced both task-independent and task-related alterations in neurophysiologic measures. The EEG and EP changes produced by TPM are consistent with an impairment of WM, as evidenced by overt performance deficits on the behavioral tasks. By contrast, the reduction in synchronous cortical activity produced by LTG was not accompanied by cognitive impairment. It is unknown whether such effects would also be observed at lower doses, such as those that often are used in monotherapy for newly diagnosed patients.
对比拉莫三嗪（LTG）和托吡酯（TPM）对与认知任务相关的静息态脑电图（EEG）及诱发电位（EP）测量指标的影响。
采用双盲、随机、交叉设计。健康成年人（N = 29）经历两个为期8周的剂量递增期、4周的药物维持期（每日300毫克）以及4周的洗脱期。在基线期、每个维持期结束时以及最终洗脱期后，于工作记忆（WM）任务期间及静息状态下记录EEG。结果：LTG虽未影响任务的明显表现，但在静息和WM任务条件下均降低了EEG功率，在6至12赫兹频率范围最为显著，并且在两种WM任务负荷下均同等程度地减弱了P300诱发电位幅度。TPM减缓了反应速度并增加了错误率。在所有条件下，它还增加了6赫兹以下的EEG功率，并降低了在困难版本WM任务中观察到的慢波幅度。
这两种药物在神经生理学测量指标上产生了与任务无关及与任务相关的改变。TPM所导致的EEG和EP变化与WM受损一致，行为任务上的明显表现缺陷即为证据。相比之下，LTG所导致的同步皮层活动减少并未伴有认知损害。对于较低剂量（如新诊断患者单药治疗时常用的剂量）是否也会观察到此类效应尚不清楚。
