Anand Amit, Shrivastava Aman, Singh Kuldeep, Barik Rakesh, Gayakwad Devshree, Jailani S, Dwivedi Sumeet
Department of Pharmacognosy, JSS College of Pharmacy, JSS Academy of Higher Education and Research, Mysuru, Karnataka, India.
Department of Pharmacology, Institute of Pharmaceutical Research, GLA University, Mathura, Uttar Pradesh, India.
CNS Neurol Disord Drug Targets. 2025;24(1):60-73. doi: 10.2174/0118715273332140240724093837.
Central Nervous System (CNS) disorders affect millions of people worldwide, with a significant proportion experiencing drug-resistant forms where conventional medications fail to provide adequate seizure control. This abstract delves into recent advancements and innovative therapies aimed at addressing the complex challenge of CNS-related drug-resistant epilepsy (DRE) management. The idea of precision medicine has opened up new avenues for epilepsy treatment. Herbs such as curcumin, ginkgo biloba, panax ginseng, bacopa monnieri, ashwagandha, and rhodiola rosea influence the BDNF pathway through various mechanisms. These include the activation of CREB, inhibition of NF-κB, modulation of neurotransmitters, reduction of oxidative stress, and anti- inflammatory effects. By promoting BDNF expression and activity, these herbs support neuroplasticity, cognitive function, and overall neuronal health. Novel antiepileptic drugs (AEDs) with distinct mechanisms of action demonstrate efficacy in refractory cases where traditional medications falter. Additionally, repurposing existing drugs for antiepileptic purposes presents a cost-effective strategy to broaden therapeutic choices. Cannabidiol (CBD), derived from cannabis herbs, has garnered attention for its anticonvulsant properties, offering a potential adjunctive therapy for refractory seizures. In conclusion, recent advances and innovative therapies represent a multifaceted approach to managing drug-resistant epilepsy. Leveraging precision medicine, neurostimulation technologies, novel pharmaceuticals, and complementary therapies, clinicians can optimize treatment outcomes and improve the life expectancy of patients living with refractory seizures. Genetic testing and biomarker identification now allow for personalized therapeutic approaches tailored to individual patient profiles. Utilizing next-generation sequencing techniques, researchers have elucidated genetic mutations.
中枢神经系统（CNS）疾病影响着全球数百万人，其中很大一部分人患有耐药性疾病，传统药物无法有效控制癫痫发作。本摘要深入探讨了旨在应对中枢神经系统相关耐药性癫痫（DRE）管理这一复杂挑战的最新进展和创新疗法。精准医学理念为癫痫治疗开辟了新途径。姜黄素、银杏、人参、假马齿苋、南非醉茄和红景天等草药通过多种机制影响脑源性神经营养因子（BDNF）通路。这些机制包括激活环磷腺苷效应元件结合蛋白（CREB）、抑制核因子κB（NF-κB）、调节神经递质、减轻氧化应激和抗炎作用。通过促进BDNF的表达和活性，这些草药有助于神经可塑性、认知功能和整体神经元健康。具有独特作用机制的新型抗癫痫药物（AEDs）在传统药物失效的难治性病例中显示出疗效。此外，将现有药物重新用于抗癫痫目的是一种具有成本效益的策略，可拓宽治疗选择。源自大麻的大麻二酚（CBD）因其抗惊厥特性而受到关注，为难治性癫痫发作提供了一种潜在的辅助治疗方法。总之，最近的进展和创新疗法代表了一种管理耐药性癫痫的多方面方法。利用精准医学、神经刺激技术、新型药物和辅助疗法，临床医生可以优化治疗效果，提高难治性癫痫患者的预期寿命。基因检测和生物标志物识别现在允许根据个体患者情况定制个性化治疗方法。利用下一代测序技术，研究人员已经阐明了基因突变。
