Saul R. Korey Department of Neurology, Laboratory of Developmental Epilepsy, Albert Einstein College of Medicine, Bronx, NY, USA.
Department of Neuroscience, Central Clinical School, Monash University, The Alfred Hospital, Melbourne, Australia; Department of Medicine (Royal Melbourne Hospital), The University of Melbourne, Melbourne, Australia.
Neurobiol Dis. 2019 Mar;123:86-99. doi: 10.1016/j.nbd.2018.06.017. Epub 2018 Jun 22.
Post-traumatic epilepsy (PTE) is diagnosed in 20% of individuals with acquired epilepsy, and can impact significantly the quality of life due to the seizures and other functional or cognitive and behavioral outcomes of the traumatic brain injury (TBI) and PTE. There is no available antiepileptogenic or disease modifying treatment for PTE. Animal models of TBI and PTE have been developed, offering useful insights on the value of inflammatory, neurodegenerative pathways, hemorrhages and iron accumulation, calcium channels and other target pathways that could be used for treatment development. Most of the existing preclinical studies test efficacy towards pathologies of functional recovery after TBI, while a few studies are emerging testing the effects towards induced or spontaneous seizures. Here we review the existing preclinical trials testing new candidate treatments for TBI sequelae and PTE, and discuss future directions for efforts aiming at developing antiepileptogenic and disease-modifying treatments.
创伤后癫痫(PTE)是获得性癫痫患者中 20%的诊断,由于创伤性脑损伤(TBI)和 PTE 的发作以及其他功能或认知和行为结果,会显著影响生活质量。目前尚无针对 PTE 的抗癫痫发生或疾病修正治疗。已经开发出 TBI 和 PTE 的动物模型,为炎症、神经退行性途径、出血和铁积累、钙通道和其他可能用于治疗开发的靶途径的价值提供了有用的见解。大多数现有的临床前研究测试了针对 TBI 后功能恢复病理学的疗效,而少数研究正在出现,测试针对诱导或自发性发作的效果。在这里,我们回顾了现有的临床前试验,测试了用于 TBI 后遗症和 PTE 的新候选治疗方法,并讨论了旨在开发抗癫痫发生和疾病修正治疗的未来方向。