Bolanos A R, Sarkisian M, Yang Y, Hori A, Helmers S L, Mikati M, Tandon P, Stafstrom C E, Holmes G L
Department of Neurology, Harvard Medical School, Children's Hospital Boston, MA 02115, USA.
Neurology. 1998 Jul;51(1):41-8. doi: 10.1212/wnl.51.1.41.
To investigate the long-term effects of two widely used antiepileptic medications, valproate and phenobarbital, on learning and behavior in the kainic acid (KA) model of epilepsy.
Prior clinical and animal studies have demonstrated that phenobarbital administered during development may result in subsequent cognitive impairment. It is unclear whether these adverse effects of phenobarbital extend to other antiepileptic drugs.
A convulsant dose of KA was administered to rats on postnatal day (P) 35. From P36-75 rats received daily injections of phenobarbital (PH), valproate (VPA), or saline and spontaneous seizure frequency was monitored with video recordings. After tapering of the drugs, the rats were tested in the water maze (a measure of visuospatial memory) and handling test (a measure of emotionality). Brains were then analyzed for histologic lesions.
KA caused status epilepticus in all the rats. In the PH- and saline-treated groups, there was impaired learning in the water maze, increased emotionality, recurrent seizures, and histologic lesions in the hippocampal areas CA3, CA1, and dentate hilus. However, VPA-treated rats had no spontaneous seizures, abnormalities in handling, or deficits in visuospatial learning, and had fewer histologic lesions than animals receiving KA alone.
The long-term consequences of AED treatment during development are related to the drug used. VPA treatment after KA-induced status epilepticus prevents many of the neurologic sequelae typically seen after KA.
研究两种广泛使用的抗癫痫药物丙戊酸盐和苯巴比妥对癫痫的红藻氨酸(KA)模型学习和行为的长期影响。
先前的临床和动物研究表明,发育期间给予苯巴比妥可能导致随后的认知障碍。尚不清楚苯巴比妥的这些不良反应是否也适用于其他抗癫痫药物。
在出生后第35天给大鼠注射惊厥剂量的KA。从出生后第36天至75天,大鼠每天接受苯巴比妥(PH)、丙戊酸盐(VPA)或生理盐水注射,并用视频记录监测自发癫痫发作频率。药物逐渐减量后,对大鼠进行水迷宫测试(一种视觉空间记忆测量方法)和处理测试(一种情绪测量方法)。然后分析大脑的组织学损伤。
KA在所有大鼠中引起癫痫持续状态。在PH治疗组和生理盐水治疗组中,大鼠在水迷宫中的学习能力受损、情绪增加、癫痫复发,并且海马区CA3、CA1和齿状回存在组织学损伤。然而,VPA治疗的大鼠没有自发癫痫发作、处理异常或视觉空间学习缺陷,并且与仅接受KA的动物相比,组织学损伤更少。
发育期间抗癫痫药物治疗的长期后果与所使用的药物有关。KA诱导的癫痫持续状态后进行VPA治疗可预防KA后通常出现的许多神经后遗症。