Institute of Neurology, Huashan Hospital, Fudan University, WHO Collaborating Centre for Research and Training in Neurosciences, Shanghai, China.
J Neurol Neurosurg Psychiatry. 2012 Dec;83(12):1139-44. doi: 10.1136/jnnp-2012-303042. Epub 2012 Jul 31.
Phenobarbital is an effective treatment for epilepsy but concerns remain over its potential neurocognitive toxicity. This prospective study evaluated the effects of phenobarbital treatment on cognition and mood in people with epilepsy in rural China.
We recruited 144 adults with convulsive seizures and 144 healthy controls from six sites in rural China. People with epilepsy were treated with phenobarbital monotherapy for 12 months. At baseline, and at 3, 6 and 12 months, cases and controls were evaluated with a battery of neuropsychological tests: the Mini-Mental State Examination, the Hamilton Depression Rating Scale, a digit span test, a verbal fluency test, an auditory verbal learning test and a digit cancellation test. Efficacy of phenobarbital treatment was evaluated at the end of follow-up for those with epilepsy.
Cognitive test scores and mood ratings were available for 136 (94%) people with epilepsy and 137 (95%) controls at the 12 month follow-up. Both groups showed slightly improved performance on a number of neuropsychological measures. The people with epilepsy showed greater performance gains (p=0.012) in verbal fluency. Nine people with epilepsy complained of memory problems during the treatment period.
In this study, phenobarbital was not found to have a major negative impact on cognitive function of people with convulsive seizures and some cognitive gains were observed, possibly due to improved seizure control.
苯巴比妥是治疗癫痫的有效药物，但仍存在其潜在神经认知毒性的担忧。本前瞻性研究评估了苯巴比妥治疗对中国农村癫痫患者认知和情绪的影响。
我们从中国农村的六个地点招募了 144 名有惊厥性发作的成年人和 144 名健康对照者。癫痫患者接受苯巴比妥单药治疗 12 个月。在基线、3 个月、6 个月和 12 个月时，病例和对照组均接受一系列神经心理测试：简易精神状态检查、汉密尔顿抑郁评定量表、数字跨度测试、言语流畅性测试、听觉词语学习测试和数字删除测试。对随访结束时接受苯巴比妥治疗的癫痫患者进行疗效评估。
在 12 个月的随访中，136 名（94%）癫痫患者和 137 名（95%）对照组可获得认知测试评分和情绪评分。两组在多项神经心理学测试中均表现出一定程度的认知能力提高。癫痫患者在言语流畅性方面表现出更大的认知改善（p=0.012）。9 名癫痫患者在治疗期间抱怨有记忆问题。
在这项研究中，苯巴比妥对惊厥性癫痫患者的认知功能没有重大负面影响，而且观察到一些认知增益，这可能归因于更好的癫痫控制。
