Schmidt A, Darius J, Brosz M, Roth N, Meyer F P, Kroker S, Wien F, Brett B
Institut für Neurobiologie, Otto-von-Geuricke-Universität, Magdeburg.
Z Kinder Jugendpsychiatr. 1995 Sep;23(3):161-70.
Valproic acid (VPA) currently plays an important role in the treatment of several different types of epilepsy. Especially in children and adolescents, VPA is used because of a minimum of adverse effects and generally little impact on cognitive and psychomotor functions. However, reports in the literature regarding the influence of VPA on behavior and cognitive performance and on EEG parameters vary widely. We investigated the effect of VPA monotherapy on behavioral components (attention, concentration, inhibitory control), cognitive efficiency (motor reaction time, learning, retention) and evoked potentials in 19 children aged 6 to 14 years with idiopathic generalized epilepsy and compared the results with those of healthy controls matched for age. In addition, we analyzed the serum levels of VPA and some of the VPA metabolites in all of the children with epilepsy immediately before the psychophysiological assessments. Our results show marked differences between the children with epilepsy and the healthy controls in all types of behavior and cognitive performance assessed. Abnormal behavior (disturbances of attention and concentration, impulsive behavior patterns) and significant changes in evoked potentials appear to be correlated with serum levels of VPA and certain VPA metabolites.
丙戊酸(VPA)目前在多种不同类型癫痫的治疗中发挥着重要作用。特别是在儿童和青少年中,使用VPA是因为其副作用最小,并且通常对认知和心理运动功能影响较小。然而,文献中关于VPA对行为、认知表现和脑电图参数影响的报道差异很大。我们调查了VPA单一疗法对19名6至14岁特发性全身性癫痫儿童的行为成分(注意力、专注力、抑制控制)、认知效率(运动反应时间、学习、记忆)和诱发电位的影响,并将结果与年龄匹配的健康对照组进行比较。此外,我们在所有癫痫儿童进行心理生理评估前,分析了他们的VPA血清水平和一些VPA代谢物。我们的结果表明,癫痫儿童与健康对照组在所有评估的行为和认知表现类型上存在显著差异。异常行为(注意力和专注力障碍、冲动行为模式)和诱发电位的显著变化似乎与VPA血清水平和某些VPA代谢物相关。