Kellogg Marissa, Meador Kimford J
Department of Neurology, Oregon Health Sciences University, 3181 SW Sam Jackson Park Rd, Mail Code 120, Portland, OR, 97239-3098, USA.
Department of Neurology & Neurological Sciences, Stanford University, Stanford, CA, USA.
Neurochem Res. 2017 Jul;42(7):2065-2070. doi: 10.1007/s11064-017-2262-4. Epub 2017 Apr 19.
Increasing evidence suggests that exposure to certain antiepileptic drugs (AEDs) during critical periods of development may induce transient or long-lasting neurodevelopmental deficits across cognitive, motor and behavioral domains. The developing nervous system may endure prolonged chronic exposure to AEDs during pregnancy (in utero) or during childhood, which can lead to neurodevelopmental defects such as congenital neural tube defects, lower IQ, language deficits, autism and ADHD. To date, valproate is the most widely recognized AED to significantly negatively affect neurodevelopment, and demonstrates greater adverse effects than any other AEDs that have been assessed. Although some AEDs appear to have low risk (i.e., lamotrigine, levetiracetam), other AEDs have been implicated in a variety of studies detailed below, and many AEDs have not been adequately assessed. The purpose of this review article is to summarize our current understanding of the neurodevelopmental effects of AEDs.
越来越多的证据表明,在发育的关键时期接触某些抗癫痫药物(AEDs)可能会在认知、运动和行为领域诱发短暂或长期的神经发育缺陷。发育中的神经系统可能在孕期(子宫内)或儿童期长期慢性接触AEDs,这可能导致神经发育缺陷,如先天性神经管缺陷、智商降低、语言缺陷、自闭症和注意力缺陷多动障碍。迄今为止,丙戊酸盐是最广为人知的对神经发育有显著负面影响的AED,并且与已评估的任何其他AED相比,其显示出更大的不良反应。尽管一些AED似乎风险较低(即拉莫三嗪、左乙拉西坦),但其他AED已在以下详述的各种研究中涉及,并且许多AED尚未得到充分评估。这篇综述文章的目的是总结我们目前对AED神经发育影响的理解。