Tumay Yener, Altun Yaşar, Ekmekci Kazm, Ozkul Yasar
Department of Neurology, Medical Faculty, Harran University, Sanliurfa, Turkey.
Clin Neuropharmacol. 2013 Mar-Apr;36(2):55-8. doi: 10.1097/WNF.0b013e318285f3da.
Although the unfavorable effects of early antiepileptic drugs, valproic acid, and carbamazepine (CBZ) on cognitive functions and visual functions have been investigated, the unfavorable effects of levetiracetam (LEV) on cognitive and visual functions remain unknown. The aim of the present study is to investigate whether there is a difference between the adverse effects by comparing the P300 and P100 latencies of LEV with epileptic patients using CBZ or sodium valproate (VPA) and healthy subjects.
A control group of 20 healthy subjects and 53 patients receiving monotherapy with CBZ (n = 15), VPA (n = 14), and LEV (n = 24) who admitted to neurology policlinic for investigation and treatment were enrolled in this study. Visual evoked potentials and event-related evoked potentials were studied according to these groups. Standard "oddball paradigm" (unpredictable stimuli series) was used to obtain P300.
The P300 latencies of epileptic patients receiving CBZ, VPA, and LEV were longer compared with the control group, and the differences were statistically significant (P = 0.001, 0.001, and 0.03, respectively). The P300 latency of patients receiving LEV was significantly shorter than the group receiving CBZ and VPA with statistically significant difference (P < 0.01 for both). The P300 amplitude was lower in the groups receiving CBZ, VPA, and LEV compared with the control group, and the difference was statistically significant (P < 0.05).
The present study shows that LEV disrupts P300 latency less than VPA and CBZ and does not prolong P100 as much as them.
尽管已对早期抗癫痫药物丙戊酸和卡马西平(CBZ)对认知功能和视觉功能的不良影响进行了研究,但左乙拉西坦(LEV)对认知和视觉功能的不良影响仍不清楚。本研究的目的是通过比较使用CBZ或丙戊酸钠(VPA)的癫痫患者及健康受试者与使用LEV的癫痫患者的P300和P100潜伏期,来研究不良反应之间是否存在差异。
本研究纳入了20名健康受试者作为对照组,以及53名因调查和治疗而入住神经内科门诊的患者,这些患者分别接受CBZ单药治疗(n = 15)、VPA单药治疗(n = 14)和LEV单药治疗(n = 24)。根据这些分组对视觉诱发电位和事件相关诱发电位进行研究。采用标准的“oddball范式”(不可预测刺激序列)来获取P300。
与对照组相比,接受CBZ、VPA和LEV治疗的癫痫患者的P300潜伏期更长,差异具有统计学意义(分别为P = 0.001、0.001和0.03)。接受LEV治疗的患者的P300潜伏期显著短于接受CBZ和VPA治疗的组,差异具有统计学意义(两者均P < 0.01)。与对照组相比,接受CBZ、VPA和LEV治疗的组的P300波幅更低,差异具有统计学意义(P < 0.05)。
本研究表明,LEV对P300潜伏期的干扰小于VPA和CBZ,且对P100的延长也不如它们。