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Bath KG, Scharfman HE. Impact of early life exposure to antiepileptic drugs on neurobehavioral outcomes based on laboratory animal and clinical research. Epilepsy Behav 2013; 26:427-39. [PMID: 23305780 PMCID: PMC3925312 DOI: 10.1016/j.yebeh.2012.10.031] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2012] [Accepted: 10/30/2012] [Indexed: 12/13/2022]
Abstract
Epilepsy affects approximately 1% of children under the age of 15, making it a very common neurological disorder in the pediatric population (Russ et al., 2012). In addition, ~0.4-0.8% of all pregnant women have some form of epilepsy (Hauser et al., 1996a,b; Borthen et al., 2009; Krishnamurthy, 2012). Despite the potential deleterious effects of antiepileptic drugs (AEDs) on the developing brain, their use is still required for seizure control in pregnant women (Krishnamurthy, 2012), and they represent the standard approach for treating children with epilepsy (Chu-Shore and Thiele, 2010; Quach et al., 2010; Verrotti et al., 2011). Even when AEDs are effective, there are potential side effects, including cognitive and affective changes or altered sleep and appetite. The consequences of AED exposure in development have been studied extensively (Canger et al., 1999; Modi et al., 2011a,b; Oguni, 2011). Despite intensive study, there is still debate about the long-term consequences of early life AED exposure. Here, we consider the evidence to date that AED exposure, either prenatally or in early postnatal life, has significant adverse effects on the developing brain and incorporate studies of laboratory animals as well as those of patients. We also note the areas of research where greater clarity seems critical in order to make significant advances. A greater understanding of the impact of AEDs on somatic, cognitive and behavioral development has substantial value because it has the potential to inform clinical practice and guide studies aimed at understanding the genetic and molecular bases of comorbid pathologies associated with common treatment regimens. Understanding these effects has the potential to lead to AEDs with fewer side effects. Such advances would expand treatment options, diminish the risk associated with AED exposure in susceptible populations, and improve the quality of life and health outcomes of children with epilepsy and children born to women who took AEDs during pregnancy.
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Affiliation(s)
- Kevin G. Bath
- Department of Neuroscience, Brown University, Box GL-N, 185 Meeting St., Providence, RI 02912, USA,Corresponding author. (K.G. Bath)
| | - Helen E. Scharfman
- The Nathan Kline Institute for Psychiatric Research, 140 Old Orangeburg Rd., Bldg. 35, Orangeburg, NY 10962, USA,New York University Langone Medical Center, 550 First Ave., New York, NY 10016, USA
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Reeta KH, Mehla J, Gupta YK. Curcumin ameliorates cognitive dysfunction and oxidative damage in phenobarbitone and carbamazepine administered rats. Eur J Pharmacol 2010; 644:106-12. [PMID: 20667451 DOI: 10.1016/j.ejphar.2010.07.022] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2010] [Revised: 06/18/2010] [Accepted: 07/11/2010] [Indexed: 12/13/2022]
Abstract
The antiepileptic drugs, phenobarbitone and carbamazepine are well known to cause cognitive impairment on chronic use. The increase in free radical generation has been implicated as one of the important mechanisms of cognitive impairment by antiepileptic drugs. Curcumin has shown antioxidant, anti-inflammatory and neuro-protective properties. Therefore, the present study was carried out to investigate the effect of chronic curcumin administration on phenobarbitone- and carbamazepine-induced cognitive impairment and oxidative stress in rats. Pharmacokinetic interactions of curcumin with phenobarbitone and carbamazepine were also studied. Vehicle/drugs were administered daily for 21days to male Wistar rats. Passive avoidance paradigm and elevated plus maze test were used to assess cognitive function. At the end of study period, serum phenobarbitone and carbamazepine, whole brain malondialdehyde and reduced glutathione levels were estimated. The administration of phenobarbitone and carbamazepine for 21days caused a significant impairment of learning and memory as well as an increased oxidative stress. Concomitant curcumin administration prevented the cognitive impairment and decreased the increased oxidative stress induced by these antiepileptic drugs. Curcumin co-administration did not cause any significant alteration in the serum concentrations of both phenobarbitone as well as carbamazepine. These results show that curcumin has beneficial effect in mitigating the deterioration of cognitive functions and oxidative damage in rats treated with phenobarbitone and carbamazepine without significantly altering their serum concentrations. The findings suggest that curcumin can be considered as a potential safe and effective adjuvant to phenobarbitone and carbamazepine therapy in preventing cognitive impairment associated with these drugs.
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Affiliation(s)
- K H Reeta
- Department of Pharmacology, All India Institute of Medical Sciences, New Delhi 110029, India
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Holmes GL. The 2008 Judith Hoyer lecture: epilepsy in children: listening to mothers. Epilepsy Behav 2009; 16:193-202. [PMID: 19720568 PMCID: PMC2760824 DOI: 10.1016/j.yebeh.2009.07.029] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2009] [Accepted: 07/17/2009] [Indexed: 12/29/2022]
Abstract
The incidence of epilepsy is significantly higher in children than adults. When faced with the diagnosis of epilepsy, parents have many questions regarding cause, treatment, and prognosis. Although the majority of children with epilepsy have an excellent prognosis and respond well to therapy, some children are refractory to therapy and suffer from cognitive decline. Animal models are now providing insights into the mechanisms responsible for the high incidence of seizures during development and age-dependent seizure-induced damage. One of the causes of the increased susceptibility of the young brain to seizures is the depolarizing effects of GABA secondary to high intracellular concentrations of chloride in young neurons. Although cell loss is not a feature of seizures in the young brain, recurrent seizures do result in aberrant sprouting of mossy fibers, reduce neurogenesis, and alter excitatory and inhibitory neurotransmitter receptor structure and function. Behavioral consequences of early-life seizures include impaired spatial cognition, which now can be assessed using single-cell recordings from the hippocampus. Antiepileptic drugs have had a tremendous positive influence in epilepsy management, although there are now a number of studies demonstrating that antiepileptic drugs at therapeutic concentrations can impair cognition and result in increased apoptosis. While clinical judgment and experience are paramount when discussing the consequences of seizures and their treatment, awareness of studies from animals can provide the clinician with guidance in addressing these important issues with parents.
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Affiliation(s)
- Gregory L Holmes
- Department of Neurology, Center for Neuroscience at Dartmouth, Dartmouth Medical School, Hanover, NH, USA.
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Postnatal concerns in children born to women with epilepsy. Epilepsy Behav 2007; 11:270-6. [PMID: 17996634 DOI: 10.1016/j.yebeh.2007.08.022] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2007] [Accepted: 08/14/2007] [Indexed: 11/22/2022]
Abstract
Infants born to mothers with epilepsy are at substantial risk for neurocognitive and behavioral disorders. Although exposure of the child to antiepileptic drugs (AEDs) during pregnancy and postnatally through breast milk has been implicated in disorders of higher cortical function, there have been relatively few clinical or animal studies examining the long-term effects of AEDs on cognition in the developing brain. In the limited animal studies done thus far, drug-specific effects on cognitive function have been identified. Phenobarbital, in particular, has been found to lead to adverse cognitive outcomes, whereas the newer AEDs have generally had more favorable outcomes. Although the pathophysiological mechanisms responsible for these deficits remain largely unknown, there is evidence that AEDs can adversely effect neuronal proliferation and migration, and increase apoptosis. While animal studies can provide valuable information regarding mechanism of AED-induced developmental pathology, they do not provide insight into cortical functions unique to humans, such as speech and language. Understanding the full spectrum of AED-induced effects on the developing brain will require both rigorous basic science and clinical studies.
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Cognitive/behavioral teratogenetic effects of antiepileptic drugs. Epilepsy Behav 2007; 11:292-302. [PMID: 17996637 PMCID: PMC2713059 DOI: 10.1016/j.yebeh.2007.08.009] [Citation(s) in RCA: 70] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2007] [Accepted: 08/14/2007] [Indexed: 11/20/2022]
Abstract
The majority of children of mothers with epilepsy are normal, but they are at increased risk for developmental delay. Antiepileptic drugs (AEDs) appear to play a role. Our current knowledge is reviewed, including research design issues and recommendations for future research. In animals, exposure of the immature brain to some AEDs can produce widespread neuronal apoptosis and behavioral deficits. The risks of AEDs in humans are less clear, but recent studies raise concerns, especially for valproate. There is a critical need for well-designed systematic research to improve our understanding of AED effects on the fetal brain.
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Middaugh LD, Dow-Edwards D, Li AA, Sandler JD, Seed J, Sheets LP, Shuey DL, Slikker W, Weisenburger WP, Wise LD, Selwyn MR. Neurobehavioral assessment: a survey of use and value in safety assessment studies. Toxicol Sci 2003; 76:250-61. [PMID: 12915715 DOI: 10.1093/toxsci/kfg211] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
This report describes the results of a survey designed to evaluate the contribution of F1 neurobehavioral testing to hazard identification and characterization in safety assessment studies. (To review the details of the distributed survey, please see the supplementary data for this article on the journal's Web site.) The survey provided information about studies completed in industrial laboratories in the United States, Europe, and Japan since 1990 on 174 compounds. The types of compounds included were pharmaceutical (81%), agricultural (7%), industrial (1%), or were undefined (10%). Information collected included the intended use of the test agent, general study design and methodology, the types and characteristics of F1 behavioral evaluations, and the frequency with which agents affected neurobehavioral parameters in comparison to other F0 and F1 generation parameters. F1 general toxicology parameters such as mortality, pre- and postweaning body weight, and food intake were assessed in most studies and were affected more frequently than other parameters by the test agents. F1 behavioral parameters were assessed less consistently across studies, and were less frequently affected by the agents tested. Although affected by agents less often than general toxicology parameters, F1 behavioral parameters along with other parameters defined the no-observed-effect level (NOEL) in 17/113 (15%) of studies and solely defined the NOEL in 3/113 (2.6%) of studies. Thus, F1 behavioral parameters sometimes improved on the standard toxicological measures of hazard identification. While not detecting agent effects as readily as some measures, the F1 behavioral parameters provide information about agent effects on specialized functions of developing offspring not provided by other standard measures of toxicity. The survey results emphasize the need for further research into the methods of behavioral assessment as well as the mechanisms underlying the neurobehavioral alterations.
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Affiliation(s)
- Lawrence D Middaugh
- Department of Psychiatry and Behavioral Science, Medical University of South Carolina, Charleston, South Carolina 29425, USA.
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Abstract
Although the vast majority of children born to women with epilepsy are normal, these children are at increased risk for both anatomic and cognitive impairments. Current evidence suggests that the defects are the result of in utero antiepileptic drug (AED) exposure combined with a genetic predispositon. However, the exact mechanisms underlying these effects remain to be delineated. AED polytherapy increases the risk, but it remains uncertain if specific AEDs pose an overall greater threat. Most women with epilepsy cannot avoid AEDs during pregnancy because of the greater risks posed by seizures to the mother and fetus. Therefore, current recommendations emphasize definitive diagnosis and the use of AED monotherapy at the lowest effective dose if treatment is indicated. Prenatal folate and multivitamins should also be given routinely to women of childbearing age who require AED therapy.
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Affiliation(s)
- Kimford J Meador
- Department of Neurology, Medical College of Georgia, 1120 15th Street (BA3410), Augusta, GA 30912, USA.
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Pizzi WJ, Newman AS, Shansky A. Primidone-induced embryolethality and DRL deficits in surviving offspring. Neurotoxicol Teratol 1998; 20:3-7. [PMID: 9511164 DOI: 10.1016/s0892-0362(97)00071-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Pregnant Sprague-Dawley rats were administered primidone (PRM) by oral gavage on gestation days 8-20 in doses of 0 or 120 mg/kg. This dose did not produce body weight differences in the dams during the dosing period nor were there differences in the birth weights of the offspring. PRM was embryolethal with only 43% of drug-treated dams maintaining their pregnancies, whereas 100% of the pregnant controls produced offspring. An analysis of resorption sites in PRM-treated dams that did not deliver showed a nearly identical number of implantation sites (12.6) compared to the litter size of controls (12.8) that delivered pups. There were no overall differences in exploratory activity levels between PRM-treated and control animals. However, in the PRM-treated females there was an absence of the sexually dimorphic increase in activity seen in control females when compared to control males. The PRM-treated males showed an impairment in the acquisition of a DRL-20 (differential reinforcement of low rates) operant schedule over a 9-week acquisition period. There were no differences in the total response rates between the groups, suggesting that this is a specific learning deficit and not a performance deficit. The results of these experiments provide evidence that prenatal PRM exposure can be embryolethal and also impair behavior in the surviving rat offspring.
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Affiliation(s)
- W J Pizzi
- Neuropsychology Laboratory, Northeastern Illinois University, Chicago 60625, USA.
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Pizzi WJ, Alexander TD, Loftus JT. Developmental and behavioral effects of prenatal primidone exposure in the rat. Pharmacol Biochem Behav 1996; 55:481-7. [PMID: 8981578 DOI: 10.1016/s0091-3057(96)00247-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Pregnant Sprague-Dawley rats were administered primidone (PRM) by oral gavage on gestation days 8-17 in doses of 0.40, and 80 mg/kg. Although these doses of PRM did not produce significant differences in litter size, birth weight, mortality, date of attainment of developmental landmarks or measures of preweaning reflex and motor development, there were a number of significant differences that developed as the animals approached and entered adulthood. When tested as adults, the 80 mg/kg male rats showed a deficit in the performance of an eight-arm radial maze task. These same animals showed a significant reduction in open field activity when tested as adults. In addition, both male and female PRM-treated animals showed reduced body weights at different periods corresponding to onset of sexual maturation during development. These findings are consistent with the larger body of literature reporting on the neurobehavioral teratology of phenobarbital, including its ability to produce lesions in the hippocampus and endocrine dysfunction resulting in reproductive deficits. These results suggest that PRM produces its adverse effects as a result of its metabolism to phenobarbital, which in turn affects the limbic system.
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Affiliation(s)
- W J Pizzi
- Department of Psychology, Northeastern Illinois University, Chicago 60625, USA
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Affiliation(s)
- J E Fisher
- Children's Hospital Research Foundation, Cincinnati, OH
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Middaugh LD, Gentry GD. Prenatal ethanol effects on reward efficacy for adult mice are gestation stage specific. Neurotoxicol Teratol 1992; 14:365-70. [PMID: 1454046 DOI: 10.1016/0892-0362(92)90044-b] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
We previously reported that adult mice exposed to ethanol throughout gestation (G5-17) responded slower than controls on reinforcement schedules which required large numbers of responses per unit of food, i.e., high fixed ratio (FR) schedules. The primary finding of the present study was that ethanol exposure during the last 5 days of gestation (G12-17) is sufficient to produce this effect whereas a similar exposure early in gestation (G5-10) is not. Both male and female mice exposed to ethanol late in gestation responded slower than either lab chow or pair-fed controls, and the effect was similar to that of mice exposed to ethanol throughout gestation (G5-17) in our earlier study. Thus, developmental events occurring late in gestation are important for the reduced reinforcing efficacy of food for prenatal-ethanol-exposed mice. In addition, the present experiment established the comparability of the sucrose and lab chow controls on this task. The results of the present study and our previous report are compatible with the hypothesis that the reduced responding on high FR schedules exhibited by prenatal-ethanol-exposed mice reflects a reduction in the efficacy of food reward. It is possible that the reduction in reward efficacy is due to altered development of neuronal systems functionally related to reward which develop late in gestation.
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Affiliation(s)
- L D Middaugh
- Medical University of South Carolina, Department of Psychiatry and Behavioral Sciences, Charleston 29425-0742
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Adams J, Vorhees CV, Middaugh LD. Developmental neurotoxicity of anticonvulsants: human and animal evidence on phenytoin. Neurotoxicol Teratol 1990; 12:203-14. [PMID: 2196420 DOI: 10.1016/0892-0362(90)90092-q] [Citation(s) in RCA: 87] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Most epileptic women delivering children each year take anticonvulsants throughout pregnancy. The teratogenic potential of anticonvulsants is most notable for phenytoin, trimethadione, valproic acid, and carbamazepine. This review focuses on the human and animal evidence for the teratogenicity of phenytoin, with emphasis on neurobehavioral end points. The Fetal Hydantoin Syndrome (FHS) consists of craniofacial defects and any two of the following: pre/postnatal growth deficiency, limb defects, major malformations, and mental deficiency. Available data suggest a prevalence of FHS of 10-30% in infants of women ingesting 100-800 mg/kg of phenytoin during the first trimester or beyond. Unfortunately, data on neurobehavioral development in FHS children is limited. Animal models of FHS have been developed and those focusing on neurobehavioral effects are reviewed. Phenytoin produces multiple behavioral dysfunctions in rat offspring at subteratogenic and nongrowth retarding doses. These behaviorally teratogenic doses produce maternal serum phenytoin concentrations in rats comparable to those found in humans. The dysfunctions in rats are dose-dependent and exposure-period-dependent, but independent of nutritional, maternal rearing, or seizure disorder confounds. Effects include vestibular dysfunction, hyperactivity and deficits in learning and memory. General comparability between the human and animal findings for phenytoin are apparent, however, difficulties with existing studies prevent precise comparisons. Animal studies have not dealt satisfactorily with the potential contribution of epileptic disease state to the FHS, with fetal brain drug concentration determinations, a complete dose-effect range, effects in multiple species (although limited nonhuman primate data exist), site of CNS injury, and the comparability of end points assessed. Human studies have not dealt satisfactorily with issues of the need for prospective study designs, separation of the effects of different anticonvulsants, or adequate long-term follow-up of cases, especially with attention to neuropsychological assessment.
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Affiliation(s)
- J Adams
- Department of Psychology, University of Massachusetts, Boston 02125-3393
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Rosselli-Austin L, Yanai J. Neuromorphological changes in mouse olfactory bulb after neonatal exposure to phenobarbital. Neurotoxicol Teratol 1989; 11:227-30. [PMID: 2755418 DOI: 10.1016/0892-0362(89)90063-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Heterogeneous Sabra mice pups were injected daily with 50 mg/kg phenobarbital (B50) or 40 mg/kg (B40) from postnatal day 2 (P2) to P21. Control litter mates (C) received vehicle injections. All animals were killed on P50 and their brains removed for histological analysis. The volumetric growth of the main olfactory bulb (MOB) was assessed in hematoxylin and eosin-stained serial sections cut in the sagittal plane. The volume of MOB was reduced 20 to 25% in barbiturate-treated mice. The greatest reductions in volume were seen in the external layers of the bulb (20 to 28%). There were moderate reductions in the internal granular layer (IGL, 6 to 20%) and no reductions in the subependymal layer that contains the migrating and immature cells. The number of prenatally-formed mitral cell neurons was unaffected by the treatment while the number of the pre- and postnatally generated granule cells was significantly reduced in the B40 group. There were no treatment effects on the sizes or packing densities of the mitral or granule cells. Like the hippocampus and the cerebellum, the developing MOB is vulnerable to barbiturate-exposure.
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Sedowofia SK, Innes J, Peter A, Alleva E, Manning A, Clayton RM. Differential effects of prenatal exposure to phenobarbital on the behaviour and neurochemistry of CBA and C57BL/6J mice. Psychopharmacology (Berl) 1989; 97:123-30. [PMID: 2496418 DOI: 10.1007/bf00443426] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Pregnant C57BL/6J and CBA mice were administered 60 mg/kg phenobarbital intraperitoneally from days 10 to 16 of gestation. On day 18 of pregnancy half of the control and drug-treated mice were killed and the embryonic brains removed for cell cultures. The remaining mice were allowed to have their litter. After cross-fostering the mice were used for behavioural studies. Pups born to drug-treated CBA mice had birth-weights similar to controls, but their weights had fallen behind controls by day 18 after birth. They were slower at attaining mature responses in tests for sensory motor development and became progressively more hyperactive (three times more active at day 18) compared to controls. Drug-exposed C57 pups also had birth weights similar to controls. After cross-fostering, 19% of control and 31% of drug-exposed pups died, but the remaining drug-exposed pups showed no deficits in weight gain. In contrast to drug-treated CBA pups, drug-exposed C57 pups were slightly quicker in attaining mature responses in some tests. There was no difference in activity between them and their controls. In neurochemical analyses, uptake of neurotransmitters by cerebral cultures from CBA showed that uptake of GABA was increased by 5%, choline by 95%, dopamine 120%, serotonin 165% and noradrenaline by 160% in cultures from drug exposed embryos compared to controls. In cerebral cultures from C57, GABA uptake was reduced by 18%, choline 33%, dopamine 35% and noradrenaline by 25%. Only serotonin uptake was increased by 182% compared to controls. Differences between C57 and CBA were also apparent in the uptake of neurotransmitters by neuronal cultures from the mesencephalon.(ABSTRACT TRUNCATED AT 250 WORDS)
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Jacobson CD, Antolick LL, Scholey R, Uemura E. The influence of prenatal phenobarbital exposure on the growth of dendrites in the rat hippocampus. BRAIN RESEARCH. DEVELOPMENTAL BRAIN RESEARCH 1988; 44:233-9. [PMID: 3224427 DOI: 10.1016/0165-3806(88)90221-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Barbiturates, such as phenobarbital (PHB), are often used during pregnancy and early neonatal life to prevent epileptic seizures, hyperbilirubinemia and the stressful effects of labor. However, the long-term consequences of barbiturate exposure during the prenatal and neonatal periods have not been fully investigated. Several studies have indicated that phenobarbital does affect the resulting morphology and neurochemistry of various components of the central nervous system. In the present study we have investigated the effects of 3 days of prenatal phenobarbital administration (days 18-20 of gestation) on the growth and development of dendrites within the CA1 region of the hippocampus in the rat. Pups were sacrificed on days 5, 10, 23, and 35 of postnatal age and the brains were processed for Golgi impregnation of neurons. The terminal and non-terminal segments of apical and basal dendrites of neurons within the CA1 region of the hippocampus were analyzed with the aid of a scanning stage on a Zeiss universal photomicroscope and a PDP 11/23 microcomputer. In general, results indicated that 3 days of prenatal PHB severely suppresses the development of the dendritic tree which normally takes place during the first 35 days of postnatal life. There are significantly less branch points and the overall dendritic length of both apical and basal dendrites is reduced. These results indicate that prenatal PHB, even for short periods of time, affects the normal morphological development of the hippocampus. Thus, the utilization of PHB in the treatment of various human prenatal disorders should be questioned.
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Affiliation(s)
- C D Jacobson
- Department of Veterinary Anatomy, Iowa State University, Ames 50011
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Middaugh LD, Ayers KL. Effects of ethanol on mature offspring of mice given ethanol during pregnancy. Alcohol Clin Exp Res 1988; 12:388-93. [PMID: 3044168 DOI: 10.1111/j.1530-0277.1988.tb00213.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Male offspring of mice maintained on isocaloric liquid diets containing either 20% ethanol or sucrose derived calories during pregnancy were tested on their ability to discriminate different ethanol doses as adults. They were trained to lever-press for a food reward on each of two levers in an operant chamber, and were then maintained on an FR20 reinforcement schedule. After response rates stabilized, ethanol discrimination training was initiated by reinforcing only responses made on the drug appropriate-lever after i.p. injections of ethanol (1.0 g/kg) or water. After learning to discriminate the 1.0 g dose, the animals' ability to discriminate doses of 0.25, 0.50, 0.75, 1.0, and 1.5 g/kg was assessed by determining the percentage of responses made on the drug lever during a 2-min test period. Compared to sucrose controls, mice exposed to alcohol in utero learned the lever response more slowly and were less responsive to injected ethanol as evidenced by a reduced effect of the drug on response rates and by a reduction in their ability to discriminate the presence of injected ethanol. The results indicate that prenatal ethanol exposure can have long term consequences which reduce the effects of ethanol in fully mature animals.
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Affiliation(s)
- L D Middaugh
- Medical University of South Carolina, Department of Psychiatry and Behavioral Sciences, Charleston 29425-0742
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Vorhees CV, Minck DR, Berry HK. Anticonvulsants and brain development. PROGRESS IN BRAIN RESEARCH 1988; 73:229-44. [PMID: 3047795 DOI: 10.1016/s0079-6123(08)60507-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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Abstract
An animal model is used to address the issue of prenatal exposure to certain antiepileptic drugs and seizure susceptibility in the offspring. Administration of doses established as median therapeutic doses in humans of phenobarbital, valproate and clonazepam to pregnant rats during the last third of gestation produced sexually dimorphic alterations in pentylenetetrazol (PTZ)-induced seizures as well as in non-convulsive (spontaneous alternation and cliff avoidance) behaviors in the offspring. Altered seizure susceptibility occurred in the absence of overtly recognizable morphological abnormalities and did not appear to reflect differences in the status of circulating drug-binding plasma proteins. Possible neural and/or metabolic mechanisms responsible for these behavioral changes are discussed.
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Martin JC, Martin DC, Mackler B, Grace R, Shores P, Chao S. Maternal barbiturate administration and offspring response to shock. Psychopharmacology (Berl) 1985; 85:214-20. [PMID: 3925485 DOI: 10.1007/bf00428417] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Gravid Sprague-Dawley-derived rats were injected SC twice daily with either 20 or 40 mg/kg pentobarbital sodium (PT), sodium phenobarbital (PH), or the same volume of the saline vehicle on days 9-21 of pregnancy. Pair-feeding was employed. Vital, developmental, and activity measures were obtained on the neonates and locomotor activity was measured from 3-10 months of age. Avoidance was measured sequentially in a shuttle box, and in an operant chamber beginning at 3 months of age. The PH-80 dams gained less weight over the gestational period, and PH-80 and PH-40 offspring had more neonatal deaths. These male offspring were hyperactive at maturity, and PH-80 rats were initially slower to escape experimenter-initiated shock. PT exposure caused transient neonatal and juvenile hyperactivity. PT rats performed more poorly on both the conditioned avoidance and Sidman shock schedules, and had significantly lower brain: body weight ratios at 1 year of age. All four drug groups outperformed the saline offspring on subject-initiated shock schedules (punishment). Sex of offspring was determined on postnatal day 4 and the sex ratio was shifted towards male births with both drugs relative to controls.
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Abstract
Compared to nonpregnant controls, pregnant mice injected with phenobarbital had lower concentrations of the drug in the plasma but equivalent concentrations in the brain. In spite of the similar concentrations in the brain, the behavioral response to phenobarbital was greater for pregnant than nonpregnant mice. These results suggest that the concentration of phenobarbital in the plasma, which is commonly used as a basis for adjusting phenobarbital dosage during pregnancy, is not an appropriate indicator of the dynamics of the drug.
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Fishman RH, Yanai J. Long-lasting effects of early barbiturates on central nervous system and behavior. Neurosci Biobehav Rev 1983; 7:19-28. [PMID: 6132355 DOI: 10.1016/0149-7634(83)90004-0] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Forty years of prescribing barbiturates to pregnant women and infants, and thirty years of animal research have shown that barbiturates affect the developing central nervous system (CNS) and behavior. This paper compiles and reviews animal and selected human literature in this research area. Early barbiturate exposure in animals reduces brain weight with related changes in brain biochemistry and neuromorphology. Significant changes may be found in surviving adult offspring. Evidence of CNS and behavioral damage in human beings due to early barbiturate exposure is not clearcut, however, confounded by the conditions for which the drugs are prescribed. In animals, early drug exposure significantly reduces levels of hormones, vitamins, and other biologically active macromolecules via (long-lasting) induction of hepatic metabolizing enzymes. Whether or not in humans treated with barbiturates, hormone levels remain within the normal range (by-feed-back regulation) and, also, if vitamin deficiencies can be simply corrected by supplements is still being debated. Early barbiturates administered to animals is associated with long-lasting disturbances in activity, learning performance, sexual behavior, and reproductive function, but not in a simple dose-exposure related manner. Animal studies show that long-lasting functional tolerance to drugs develops following early barbiturate exposure. Although infants become "passively addicted" following in utero exposure, there is as yet no data on subsequent development of human adult tolerance. Drug related damage must, in any case, be weighed against therapeutic benefits of drug administration and the results of failure to treat.
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Yanai J, Woolf M, Feigenbaum JJ. Autoradiographic study of phenobarbital's effect on development of the central nervous system. Exp Neurol 1982; 78:437-49. [PMID: 7140906 DOI: 10.1016/0014-4886(82)90061-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Reinisch JM, Sanders SA. Early barbiturate exposure: the brain, sexually dimorphic behavior and learning. Neurosci Biobehav Rev 1982; 6:311-9. [PMID: 7177507 DOI: 10.1016/0149-7634(82)90043-4] [Citation(s) in RCA: 38] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Barbiturates, one of the most widely prescribed and abused classes of drugs, reportedly have been prescribed in as many as 25% of pregnancies in the U.S. and Europe over the last 30 years. Nevertheless, there exists little if any data on long-term consequences of prenatal exposure to barbiturates in humans. Evidence from laboratory animals indicates that exposure to barbiturates during early developmental periods results in abnormal neural and biochemical differentiation of the central nervous system, deficits in learning, retarded attainment of developmental milestones, alteration of behavioral and physiological sex differences, increased activity, and decreased responsiveness to aversive and appetitive stimuli. Barbiturates appear to influence the brain via two routes: (1) by direct action on neural tissue; and (2) indirectly by altering hepatic metabolism of steroid hormones. It is concluded that prenatal exposure to barbiturates in human subjects may lead to learning disabilities, decreased IQ, performance deficits, increased incidence of psychosocial maladjustment, and demasculinization of gender identity and sex role behavior in males.
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Gai N, Grimm VE. The effect of prenatal exposure to diazepam on aspects of postnatal development and behavior in rats. Psychopharmacology (Berl) 1982; 78:225-9. [PMID: 6818579 DOI: 10.1007/bf00428155] [Citation(s) in RCA: 64] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
In the present study the effects of chronic treatment of pregnant rats with diazepam on the physical and behavioral development of their offspring were investigated. Rats that were diazepam-exposed prenatally were compared to age-matched controls in terms of the following: number of littermates; birth weight and weight gain until weaning: motor development and coordination; simple motor learning; open field activity; performance on learning tasks of varying complexity; retention of these tasks. Nulliparous Wistar rats were injected s.c. for 16 days of their pregnancy was either 2.5, 5, of 10 mg/kg diazepam or an equal volume of vehicle. Prenatal diazepam treatment did not alter litter size, birth weight, or the righting reflex, but seemed to retard early motor development transiently. Diazepam pups showed longer latencies and less rearing in the open field. There were no differences between animals exposed to drug and vehicle in simple motor learning or in acquiring a simple successive discrimination task. However, there were significant dose-dependent differences on a complex six-choice simultaneous discrimination learning task, the diazepam-exposed rats making more errors and taking more time to reach the goal. A significant difference was seen again between diazepam- and vehicle-exposed rats on the retention test 10 days later. The results indicate that diazepam administered to pregnant rats has long-range effects on the behavior of the offspring, some becoming manifest even in maturity.
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Middaugh LD, Simpson LW, Thomas TN, Zemp JW. Prenatal maternal phenobarbital increases reactivity and retards habituation of mature offspring to environmental stimuli. Psychopharmacology (Berl) 1981; 74:349-52. [PMID: 6794080 DOI: 10.1007/bf00432745] [Citation(s) in RCA: 30] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Adult female offspring of C57BL/6J mice injected daily with phenobarbital for the last third of pregnancy were more active than control offspring during a 3-min test period in an open field arena, thus confirming previous reports of lasting effects of prenatal exposure to phenobarbital. These offspring habituated less rapidly than control offspring to the open field and were more reactive to sudden changes in environmental stimuli. The behavioral changes were not accompanied by body or brain weight deficits. The maternal drug injections did not alter brain concentrations of dopamine or norepinephrine in the adult offspring or the degree of reduction in these transmitters produced by the synthesis inhibitors alpha-methyltyrosine. Although activity was reduced by the catecholamine synthesis inhibitor, the effect was similar by offspring of both drug-treated and control dams.
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Yanai J, Rosselli-Austin L, Tabakoff B. Neuronal deficits in mice following prenatal exposure to phenobarbital. Exp Neurol 1979; 64:237-44. [PMID: 428502 DOI: 10.1016/0014-4886(79)90265-6] [Citation(s) in RCA: 66] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Yanai J. Long-term induction of microsomal drug oxidizing system in mice following prenatal exposure to barbiturate. Biochem Pharmacol 1979; 28:1429-30. [PMID: 444320 DOI: 10.1016/0006-2952(79)90448-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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30
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Middaugh LD, Boggan WO, Wilson-Burrows C, Zemp JW. Prenatal maternal phenobarbital alters plasma concentrations of corticosterone in developing offspring. Life Sci 1979; 24:999-1002. [PMID: 571948 DOI: 10.1016/0024-3205(79)90318-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Some Quantitative Behavioral Pharmacology in the Mouse. ACTA ACUST UNITED AC 1979. [DOI: 10.1016/b978-0-12-004702-4.50006-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register]
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32
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Behavioral Teratology: Embryopathic and Behavioral Effects of Drugs During Pregnancy. ACTA ACUST UNITED AC 1978. [DOI: 10.1016/b978-0-12-609304-9.50009-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register]
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