Oommen Joseph, Kraus Alli C, Fisher Robert S
Department of Neurology, University of Texas at Galveston, United States.
Neurosci Lett. 2007 May 7;417(3):308-11. doi: 10.1016/j.neulet.2007.02.051. Epub 2007 Feb 23.
We investigated efficacy of prolonged intraventricular gabapentin (GBP) infusion in the rat flurothyl epilepsy model.
Sprague-Dawley rats, under anesthesia, were implanted with bilateral Alzet model 2001 osmotic pumps. The pumps infused GBP 80 microg/microL (3.8 mg/day) or isotonic saline control at 1.0 microL/h into each ventricle for 5 days. After 5 days of GBP infusion, seizures were induced by flurothyl dripped onto filter paper. Time to first myoclonic jerk, first partial seizure and first tonic-clonic seizure was recorded by an observer unaware of the treatment group. Determination of seizures was behavioral.
Data were obtained from 54 rats. First tonic-clonic seizure was at 295.8+/-58.8s (n=28) for control rats, versus 338.0+/-89.9 s (n=26) for rats with GBP in the pump (p=0.049). First myoclonic jerk occurred at 158.7+/-20.8 versus 164.6+/-33.5 s (p=0.44, n.s.). Regression of time to seizure versus weight was not significant. No animal had measurable serum levels (<1 microg/ml) of GBP. The distribution of GBP in brain was not studied, but qualitative observations of methylene blue dye installed in the pumps showed dye in periventricular white matter and also over cortex, especially ipsilaterally.
GBP instilled into the lateral ventricles by pump for 5 days delays onset of generalized tonic-clonic seizures produced by flurothyl in the rat. Time to first myoclonic or partial seizure was not influenced. Effects were not due to systemic absorption of GBP. This study provides a proof-in-principle for intraventricular therapy with AEDs.
我们研究了在大鼠氟烷癫痫模型中长时间脑室内注入加巴喷丁(GBP)的疗效。
在麻醉状态下,将双侧Alzet 2001型渗透泵植入斯普拉格-道利大鼠体内。泵以1.0微升/小时的速度向每个脑室内注入80微克/微升的GBP(3.8毫克/天)或等渗盐水对照,持续5天。在注入GBP 5天后,将氟烷滴在滤纸上诱发癫痫发作。由不知道治疗组情况的观察者记录首次肌阵挛性抽搐、首次部分性发作和首次强直-阵挛性发作的时间。癫痫发作的判定基于行为表现。
从54只大鼠获取了数据。对照大鼠首次强直-阵挛性发作时间为295.8±58.8秒(n = 28),而泵内注入GBP的大鼠为338.0±89.9秒(n = 26)(p = 0.049)。首次肌阵挛性抽搐分别出现在158.7±20.8秒和164.6±33.5秒(p = 0.44,无统计学意义)。癫痫发作时间与体重的回归分析无显著意义。没有动物的GBP血清水平可测(<1微克/毫升)。未研究GBP在脑内的分布情况,但对泵内注入亚甲蓝染料的定性观察显示,染料出现在脑室周围白质以及皮质,尤其是同侧皮质。
通过泵向侧脑室内注入GBP 5天可延迟大鼠因氟烷诱发的全身性强直-阵挛性发作的起始时间。首次肌阵挛性或部分性发作时间未受影响。其作用并非由于GBP的全身吸收。本研究为抗癫痫药物的脑室内治疗提供了原理性证明。