Kim Gun Ha, Byeon Jung Hye, Eun Baik Lin
Department of Pediatrics, Korea University College of Medicine, Seoul, Korea.
J Clin Neurol. 2017 Apr;13(2):138-143. doi: 10.3988/jcn.2017.13.2.138. Epub 2017 Mar 6.
Lacosamide (LCM) is an antiepileptic drug that enhances the slow inactivation of sodium channels and modulates collapsin response mediator protein-2. LCM was recently demonstrated to exert a neuroprotective effect in a murine model of traumatic brain injury and status epilepticus. Assuming the same underlying excitotoxicity-related brain injury mechanism, we hypothesized that LCM would have a neuroprotective effect in hypoxic-ischemic brain injury.
We divided rats into three groups at each testing session: pre- or postfed with LCM, fed with normal saline, and sham. A hypoxic-ischemic brain injury was induced by subjecting 7-day-old rats to right carotid artery coagulation followed by 2.5 h of exposure to 8% oxygen. The animals were killed on postnatal day 12 to evaluate the severity of brain damage. Open field testing was also performed between week 2 and week 6, and the Morris water maze test was performed in week 7 after hypoxia-ischemia.
The incidence of liquefactive cerebral infarction was lower in rats prefed with LCM at 100 mg/kg/dose, with the mortality rate being higher at higher doses (200 and 300 mg/kg/dose). The infarct areas were smaller in LCM-prefed rats in several brain regions including the hemisphere, hippocampus, cortex, and striatum. Spatial learning and memory function were better in LCM-prefed rats (p<0.05). No effect was observed in postfed rats.
This study suggests that LCM pretreatment exerts a neuroprotective effect on hypoxia-ischemia in neonatal rats. The obtained results suggest that LCM pretreatment could be used as an effective neuroprotective method for neonates under hypoxic-ischemic conditions including heart surgery.
拉科酰胺(LCM)是一种抗癫痫药物,可增强钠通道的缓慢失活并调节塌陷反应介导蛋白-2。最近有研究表明,LCM在创伤性脑损伤和癫痫持续状态的小鼠模型中具有神经保护作用。假设存在相同的潜在兴奋性毒性相关脑损伤机制,我们推测LCM在缺氧缺血性脑损伤中也具有神经保护作用。
在每次测试中,我们将大鼠分为三组:LCM预饲或后饲组、生理盐水饲组和假手术组。对7日龄大鼠进行右颈动脉结扎,然后暴露于8%氧气环境中2.5小时,以诱导缺氧缺血性脑损伤。在出生后第12天处死动物,以评估脑损伤的严重程度。在缺氧缺血后第2周和第6周之间还进行了旷场试验,并在第7周进行了莫里斯水迷宫试验。
100mg/kg剂量LCM预饲的大鼠液化性脑梗死发生率较低,而较高剂量(200和300mg/kg剂量)时死亡率较高。在包括半球、海马、皮质和纹状体在内的几个脑区,LCM预饲的大鼠梗死面积较小。LCM预饲的大鼠空间学习和记忆功能更好(p<0.05)。后饲大鼠未观察到效果。
本研究表明,LCM预处理对新生大鼠缺氧缺血具有神经保护作用。所得结果表明,LCM预处理可作为包括心脏手术在内的缺氧缺血条件下新生儿有效的神经保护方法。