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Miziak B, Błaszczyk B, Chrościńska-Krawczyk M, Czuczwar SJ. Caffeine and Its Interactions with Antiseizure Medications-Is There a Correlation between Preclinical and Clinical Data? Int J Mol Sci 2023; 24:17569. [PMID: 38139396 PMCID: PMC10744211 DOI: 10.3390/ijms242417569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 12/03/2023] [Accepted: 12/15/2023] [Indexed: 12/24/2023] Open
Abstract
Experimental studies reveal that caffeine (trimethylxanthine) at subconvulsive doses, distinctly reduced the anticonvulsant activity of numerous antiseizure medications (ASMs) in rodents, oxcarbazepine, tiagabine and lamotrigine being the exceptions. Clinical data based on low numbers of patients support the experimental results by showing that caffeine (ingested in high quantities) may sharply increase seizure frequency, considerably reducing the quality of patients' lives. In contrast, this obviously negative activity of caffeine was not found in clinical studies involving much higher numbers of patients. ASMs vulnerable to caffeine in experimental models of seizures encompass carbamazepine, phenobarbital, phenytoin, valproate, gabapentin, levetiracetam, pregabalin and topiramate. An inhibition of R-calcium channels by lamotrigine and oxcarbazepine may account for their resistance to the trimethylxanthine. This assumption, however, is complicated by the fact that topiramate also seems to be a blocker of R-calcium channels. A question arises why large clinical studies failed to confirm the results of experimental and case-report studies. A possibility exists that the proportion of patients taking ASMs resistant to caffeine may be significant and such patients may be sufficiently protected against the negative activity of caffeine.
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Affiliation(s)
- Barbara Miziak
- Department of Pathophysiology, Medical University of Lublin, 20-090 Lublin, Poland;
| | - Barbara Błaszczyk
- Faculty of Medical Sciences, Lipinski University, 25-734 Kielce, Poland;
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Chwedorowicz R, Łukawski K, Raszewski G, Czuczwar SJ. Caffeine impairs anticonvulsant effects of levetiracetam in the maximal electroshock seizure threshold test in mice. J Basic Clin Physiol Pharmacol 2023; 34:357-364. [PMID: 36420661 DOI: 10.1515/jbcpp-2022-0224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 11/08/2022] [Indexed: 05/17/2023]
Abstract
OBJECTIVES Caffeine is the most widely used psychoactive substance in the world. Animal studies indicate that acute caffeine exposure at high doses may induce seizures and diminish the anticonvulsant activity of antiepileptic drugs (AEDs) at much lower doses. The aim of the current study was to assess the effect of caffeine on the anticonvulsant action of levetiracetam (LEV) and vigabatrin (VGB). METHODS The anticonvulsant activity of LEV and VGB was examined in the maximal electroshock seizure threshold test in mice (MEST test). All drugs were administered intraperitoneally by single injections, and caffeine was applied at doses capable of interfering with AEDs. Effects of caffeine exposure on AEDs were also investigated in tests of memory and motor performance. RESULTS Caffeine reduced the protective effect of LEV against electroconvulsions. Total brain concentration of LEV was unaffected by caffeine as well as inversely; LEV had no significant impact on the brain caffeine concentration, suggesting a pharmacodynamic nature of the interaction between LEV and caffeine in the MEST test. VGB at applied doses did not affect the convulsive threshold. Administration of VGB, but not LEV, alone or in combination with caffeine, impaired memory retention. In the chimney test, the combined treatment with AEDs and caffeine did not cause motor coordination impairment. CONCLUSIONS It is suggested that caffeine may negatively affect the anticonvulsant action of LEV in patients with epilepsy.
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Affiliation(s)
- Roman Chwedorowicz
- Department of Physiopathology, Institute of Rural Health, Lublin, Poland
| | - Krzysztof Łukawski
- Department of Physiopathology, Institute of Rural Health, Lublin, Poland
| | - Grzegorz Raszewski
- Department of Toxicology and Food Protection, Institute of Rural Health, Lublin, Poland
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Tomsone LE, Perkons I, Sukajeva V, Neilands R, Kokina K, Bartkevics V, Pugajeva I. Consumption trends of pharmaceuticals and psychoactive drugs in Latvia determined by the analysis of wastewater. WATER RESEARCH 2022; 221:118800. [PMID: 35810631 DOI: 10.1016/j.watres.2022.118800] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 06/01/2022] [Accepted: 06/25/2022] [Indexed: 06/15/2023]
Abstract
Wastewater-based epidemiology (WBE) was applied to evaluate seasonal variations of the consumption of pharmaceuticals (i.e. antibiotics, NSAIDs, antiepileptics, antihypertensives and others), caffeine, alcohol and nicotine in Latvia throughout 2021. In addition, weekly variation of caffeine, nicotine and alcohol consumption was investigated. Pronounced seasonality was observed in the consumption of antibiotics and decongestants, as well as caffeine, nicotine and alcohol. Correlation with COVID-19 statistics was observed in the case of macrolide antibiotics and antiasthmatic salbutamol. Comparison of the estimated consumption values obtained using the WBE approach and the statistics revealed that the majority of compounds data are in good agreement except angiotensin II receptor blocker group antihypertensives where the most overestimated consumption values were observed.
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Affiliation(s)
- Laura Elina Tomsone
- Institute of Food Safety, Animal Health and Environment "BIOR", Lejupes Street 3, Riga LV-1076, Latvia.
| | - Ingus Perkons
- Institute of Food Safety, Animal Health and Environment "BIOR", Lejupes Street 3, Riga LV-1076, Latvia
| | - Veronika Sukajeva
- Institute of Food Safety, Animal Health and Environment "BIOR", Lejupes Street 3, Riga LV-1076, Latvia
| | - Romans Neilands
- Faculty of Civil Engineering, Department of Water Engineering and Technology, Riga Technical University, Kipsalas Street 6B, Riga LV-1048, Latvia; Riga Water Ltd, Dzintara Street 60, Riga, Latvia LV-1016, Latvia
| | - Kristina Kokina
- Institute of Food Safety, Animal Health and Environment "BIOR", Lejupes Street 3, Riga LV-1076, Latvia; Faculty of Civil Engineering, Water Research and Environmental Biotechnology Laboratory, Riga Technical University, Paula Valdena Street 1, Riga LV-1048, Latvia
| | - Vadims Bartkevics
- Institute of Food Safety, Animal Health and Environment "BIOR", Lejupes Street 3, Riga LV-1076, Latvia
| | - Iveta Pugajeva
- Institute of Food Safety, Animal Health and Environment "BIOR", Lejupes Street 3, Riga LV-1076, Latvia
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Shen HY, Baer SB, Gesese R, Cook JM, Weltha L, Coffman SQ, Wu J, Chen JF, Gao M, Ji T. Adenosine-A 2A Receptor Signaling Plays a Crucial Role in Sudden Unexpected Death in Epilepsy. Front Pharmacol 2022; 13:910535. [PMID: 35754505 PMCID: PMC9218562 DOI: 10.3389/fphar.2022.910535] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 05/16/2022] [Indexed: 11/16/2022] Open
Abstract
Adenosinergic activities are suggested to participate in SUDEP pathophysiology; this study aimed to evaluate the adenosine hypothesis of SUDEP and specifically the role of adenosine A2A receptor (A2AR) in the development of a SUDEP mouse model with relevant clinical features. Using a combined paradigm of intrahippocampal and intraperitoneal administration of kainic acid (KA), we developed a boosted-KA model of SUDEP in genetically modified adenosine kinase (ADK) knockdown (Adk+/-) mice, which has reduced ADK in the brain. Seizure activity was monitored using video-EEG methods, and in vivo recording of local field potential (LFP) was used to evaluate neuronal activity within the nucleus tractus solitarius (NTS). Our boosted-KA model of SUDEP was characterized by a delayed, postictal sudden death in epileptic mice. We demonstrated a higher incidence of SUDEP in Adk+/- mice (34.8%) vs. WTs (8.0%), and the ADK inhibitor, 5-Iodotubercidin, further increased SUDEP in Adk+/- mice (46.7%). We revealed that the NTS level of ADK was significantly increased in epileptic WTs, but not in epileptic Adk+/- mutants, while the A2AR level in NTS was increased in epileptic (WT and Adk+/-) mice vs. non-epileptic controls. The A2AR antagonist, SCH58261, significantly reduced SUDEP events in Adk+/- mice. LFP data showed that SCH58261 partially restored KA injection-induced suppression of gamma oscillation in the NTS of epileptic WT mice, whereas SCH58261 increased theta and beta oscillations in Adk+/- mutants after KA injection, albeit with no change in gamma oscillations. These LFP findings suggest that SCH58261 and KA induced changes in local neuronal activities in the NTS of epileptic mice. We revealed a crucial role for NTS A2AR in SUDEP pathophysiology suggesting A2AR as a potential therapeutic target for SUDEP risk prevention.
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Affiliation(s)
- Hai-Ying Shen
- Department of Neuroscience, Legacy Research Institute, Portland, OR, United States
| | - Sadie B Baer
- Department of Neuroscience, Legacy Research Institute, Portland, OR, United States
| | - Raey Gesese
- Department of Neuroscience, Legacy Research Institute, Portland, OR, United States
| | - John M Cook
- Department of Neuroscience, Legacy Research Institute, Portland, OR, United States
| | - Landen Weltha
- Department of Neuroscience, Legacy Research Institute, Portland, OR, United States
| | - Shayla Q Coffman
- Department of Neuroscience, Legacy Research Institute, Portland, OR, United States
| | - Jie Wu
- Department of Neurobiology, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ, United States
| | - Jiang-Fan Chen
- Molecular Neuropharmacology Laboratory, School of Optometry and Ophthalmology and Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Ming Gao
- Department of Neurobiology, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ, United States
| | - Teng Ji
- Department of Pediatric Neurology, Randall Children's Hospital, Legacy Emanuel Medical Center, Portland, OR, United States
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5
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Bourgeois-Vionnet J, Ryvlin P, Elsensohn MH, Michel V, Valton L, Derambure P, Frazzini V, Hirsch E, Maillard L, Bartolomei F, Biberon J, Petit J, Biraben A, Crespel A, Thomas P, Lemesle-Martin M, Convers P, Leclercq M, Boulogne S, Roy P, Rheims S. Coffee consumption and seizure frequency in patients with drug-resistant focal epilepsy. Epilepsy Behav 2022; 126:108486. [PMID: 34929474 DOI: 10.1016/j.yebeh.2021.108486] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 11/28/2021] [Accepted: 11/29/2021] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To assess the relation between coffee consumption and seizure frequency in patients with drug-resistant focal epilepsy. METHODS Cross-sectional analysis of data collected in the SAVE study, which included patients with drug-resistant focal epilepsy during long-term EEG monitoring. Patients in whom both coffee consumption and data about seizure frequency, including focal to bilateral tonic-clonic seizures (FBTCS), were available were selected. Coffee consumption was collected using a standardized self-report questionnaire and classified into four groups: none, rare (from less than 1 cup/week to up 3 cups/week), moderate (from 4 cups/week to 3 cups/day), and high (more than 4 cups/day). RESULTS Six hundred and nineteen patients were included. There was no relation between coffee consumption and total seizure frequency (p = 0.902). In contrast, the number of FBTCS reported over the past year was significantly associated with usual coffee consumption (p = 0.029). Specifically, number of FBCTS in patients who reported moderate coffee consumption was lower than in others. In comparison with patients with moderate coffee consumption, the odds ratio (95%CI) for reporting at least 1 FBTCS per year was 1.6 (1.03-2.49) in patients who never take coffee, 1.62 (1.02-2.57) in those with rare consumption and 2.05 (1.24-3.4) in those with high consumption. Multiple ordinal logistic regression showed a trend toward an association between coffee consumption and number of FBTCS (p = 0.08). CONCLUSIONS AND RELEVANCE Our data suggest that effect of coffee consumption on seizures might depend on dose with potential benefits on FBTCS frequency at moderate doses. These results will have to be confirmed by prospective studies.
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Affiliation(s)
- Julie Bourgeois-Vionnet
- Department of Functional Neurology and Epileptology, Hospices Civils de Lyon and University of Lyon, Lyon, France
| | - Philippe Ryvlin
- Department of Clinical Neurosciences, Centre Hospitalo-Universitaire Vaudois, Lausanne, Switzerland
| | - Mad-Hélénie Elsensohn
- Lyon University, Lyon, France; Équipe Biostatistique Santé, Laboratoire de Biométrie et Biologie Évolutive, CNRS UMR 5558, Villeurbanne, France; Service de Biostatistique-Bioinformatique, Pôle Santé Publique, Hospices Civils de Lyon, Lyon, France
| | | | - Luc Valton
- Clinical Neurophysiology, Department of Neurology, University Hospital of Toulouse, CerCO CNRS UMR 5549, University of Toulouse, France
| | - Philippe Derambure
- Department of Clinical Neurophysiology, Lille University Medical Center, EA 1046, University of Lille 2, France
| | - Valerio Frazzini
- Epileptology Unit, Assistance Publique-Hôpitaux de Paris, Groupe hospitalier Pitié-Salpêtrière and Brain and Spine Institute (ICM; INSERM UMRS1127, CNRS UMR7225, UPMC University Paris 06), Paris, France
| | - Edouard Hirsch
- Department of Neurology, University Hospital of Strasbourg, Strasbourg, France
| | - Louis Maillard
- Neurology Department, University Hospital of Nancy, Nancy, France
| | - Fabrice Bartolomei
- Clinical Neurophysiology and Epileptology Department, Timone Hospital, Marseille, France
| | - Julien Biberon
- Department of Clinical Neurophysiology, INSERM U930, University Hospital of Tours, Tours, France
| | - Jerôme Petit
- La Teppe Epilepsy Center, Tain l'Hermitage, France
| | - Arnaud Biraben
- Department of Neurology, University Hospital of Rennes, Rennes, France
| | | | - Pierre Thomas
- Neurology Department University Hospitals of Nice, Nice, France
| | | | - Philippe Convers
- Department of Neurology, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Mathilde Leclercq
- Department of Functional Neurology and Epileptology, Hospices Civils de Lyon and University of Lyon, Lyon, France
| | - Sébastien Boulogne
- Department of Functional Neurology and Epileptology, Hospices Civils de Lyon and University of Lyon, Lyon, France; Lyon's Neuroscience Research Center, INSERM U1028 / CNRS UMR 5292 and Lyon 1 University, Lyon, France
| | - Pascal Roy
- Lyon University, Lyon, France; Équipe Biostatistique Santé, Laboratoire de Biométrie et Biologie Évolutive, CNRS UMR 5558, Villeurbanne, France; Service de Biostatistique-Bioinformatique, Pôle Santé Publique, Hospices Civils de Lyon, Lyon, France
| | - Sylvain Rheims
- Department of Functional Neurology and Epileptology, Hospices Civils de Lyon and University of Lyon, Lyon, France; Lyon's Neuroscience Research Center, INSERM U1028 / CNRS UMR 5292 and Lyon 1 University, Lyon, France; Epilepsy Institute, Lyon, France.
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Puteikis K, Streckytė D, Pociuvienė G, Wolf P, Mameniškienė R. How are results of EEG activation procedures associated with patient perception of seizure provocative factors? A single-center cross-sectional pilot study. Epilepsy Res 2020; 167:106438. [PMID: 32810766 DOI: 10.1016/j.eplepsyres.2020.106438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 07/02/2020] [Accepted: 08/01/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE The purpose of this study was to examine the relationship between subjectively perceived seizure provocative factors or inhibitors and objectively recorded changes in epileptiform activity (EA) during EEG activation procedures. MATERIAL AND METHODS Consenting epilepsy patients (≥18 years old) were asked to complete a questionnaire by indicating whether items on a list provoke, inhibit or have no effect on their seizures. A scalp EEG was recorded afterwards to evaluate baseline epileptiform activity and its change (increase/decrease in frequency) during a set of activation procedures. These included hyperventilation, intermittent photic stimulation (IPS), eye-closing/eye-opening, tasks of reading aloud in a native and a foreign language, solving a Rubik's cube and crossing-out letters. We used correlation and multiple regression analysis to search for associations between the sum of self-reported provocative/inhibiting items and changes in EA. RESULTS Of the 90 patients recruited 75 (83.3%) indicated at least one seizure provocative factor. Sleep deprivation, emotional stress, negative emotions and alcohol use were most frequently selected as provoking seizures. Positive feelings, focused thinking, mental calculation and exercising were the most predominant seizure inhibitors. EEG data revealed a weak, but statistically significant correlation with the sum of items in distinct questionnaire groups (0.20 ≤ Spearman's ρ ≤ 0.39). Sensory stimuli (olfactory, gustatory, auditory and visual), cognitive phenomena (thoughts and feelings) and substance use were found to be significantly correlated with EEG results by being self-reported as both provoking and inhibiting seizures. A statistically significant relationship was also found between the increase in EA while reading aloud in a native language and the number of physiological states (sleep deprivation, stress etc.) indicated as provoking seizures (Spearman's ρ = 0.320, P = 0.005). A suitable stepwise multiple regression model was feasible for this finding (F(3, 71) = 7.396, P < 0.001, adjusted R squared = 0.206) with the additional inclusion of EA change during IPS and epilepsy type as explanatory variables. CONCLUSION Our pilot study indicates that there is a previously non-explored association between patients' self-perception of seizure provocative/inhibiting factors and objectively recorded changes in epileptiform activity during activation EEGs. Distinct EEG tests might be useful in activating ictogenic networks that are sensitive to indirect influence by hormonal, emotional or diurnally variable factors.
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Affiliation(s)
- Kristijonas Puteikis
- Vilnius University, Faculty of Medicine, Vilnius, Lithuania; M. K. Čiurlionio str. 21, LT-03101, Vilnius, Lithuania.
| | - Dovilė Streckytė
- Vilnius University, Faculty of Medicine, Vilnius, Lithuania; M. K. Čiurlionio str. 21, LT-03101, Vilnius, Lithuania
| | - Gabrielė Pociuvienė
- Vilnius University, Faculty of Medicine, Vilnius, Lithuania; M. K. Čiurlionio str. 21, LT-03101, Vilnius, Lithuania
| | - Peter Wolf
- Danish Epilepsy Centre Filadelfia, Dianalund, Denmark; Programa de Pós-Graduação em Ciências Médicas, Universidad Federal de Santa Catarina, Florianópolis, SC, Brazil
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Jailani M, Mubarak M, Sarkhouh M, Al Mahrezi A, Abdulnabi H, Naiser M, Alaradi H, Alabbad A, Hassan M, Kamal A. The Effect of Low-Doses of Caffeine and Taurine on Convulsive Seizure Parameters in Rats. Behav Sci (Basel) 2020; 10:bs10020043. [PMID: 32012788 PMCID: PMC7071385 DOI: 10.3390/bs10020043] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Revised: 01/16/2020] [Accepted: 01/23/2020] [Indexed: 12/26/2022] Open
Abstract
Introduction: Caffeine, an adenosine-receptor blocker, is believed to have neuronal excitatory effects, while Taurine, a mammalian amino acid, was shown to have neuroinhibitory effects. Aim: The aim of this study was to investigate the effects of acute and chronic administration of low doses of Caffeine and Taurine on the seizure threshold in rats. Methods: Six-week-old Sprague-Dawley male rats (n = 280) were divided randomly into five groups (control, acute caffeine intake, acute taurine intake, chronic caffeine intake and chronic taurine intake), with five subgroups per group according to five different doses of Pentylenetetrazole (PTZ) injections. Each subgroup consisted of eight rats. Data was entered and analyzed using Microsoft EXCEL and AddinsoftTM XLSTAT (Version 2012.6.06; New York, NY, USA). p-value = 0.05 was regarded as statistically significant. Results: There was a significant decrease in the latency of PTZ-induced seizures with both acute (p-value < 0.05) and chronic (p-value < 0.01) Caffeine treatment groups. Chronic exposure to Caffeine exhibited an increase in the probability of seizures (p-value < 0.05). However, acute exposure to Caffeine did not show a significant impact on the probability of seizures. Neither acute nor chronic exposures to Taurine had an effect on the probability of seizures, nor on the latency of PTZ-induced seizures. Discussion: Our study found that acute as well as chronic exposure to low doses of Caffeine (50 and 80 mg/kg) reduces the threshold, and hence increases the likelihood for seizures since it favors a state of neuronal hyper excitability through blocking of all adenosine receptors. On the other hand, acute or chronic exposure to Taurine did not show a significant effect on the PTZ-induced seizures parameters.
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Abstract
PURPOSE OF REVIEW Caffeine is the most widely consumed central nervous stimulant. For people with epilepsy, it is often unclear whether drinking coffee carries a risk of triggering seizures. RECENT FINDINGS The relationship between caffeine, seizures, epilepsy, and anti-seizure drugs is not fully understood. Clinical studies are scarce. In animal models, caffeine can increase seizure susceptibility but can also protect from seizures. Effects seem dose-dependent and are influenced by the duration of intake and the developmental stage at which caffeine exposure started. Caffeine reduces the efficacy of several anti-seizure medications, especially topiramate. It is unclear how these findings, mainly from animal studies, can be translated to the clinical condition. At present, there is no evidence to advise people with epilepsy against the use or overuse of caffeine. Until clinical studies suggest otherwise, caffeine intake should be considered as a factor in achieving and maintaining seizure control in epilepsy.
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Esmaili Z, Heydari A. Involvement of nitric oxide in the effect of caffeine on the pentylenetetrazole-induced seizure threshold in mice. THE JOURNAL OF QAZVIN UNIVERSITY OF MEDICAL SCIENCES 2018. [DOI: 10.29252/qums.22.5.4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
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van Koert RR, Bauer PR, Schuitema I, Sander JW, Visser GH. Caffeine and seizures: A systematic review and quantitative analysis. Epilepsy Behav 2018; 80:37-47. [PMID: 29414557 DOI: 10.1016/j.yebeh.2017.11.003] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Revised: 10/31/2017] [Accepted: 11/01/2017] [Indexed: 01/30/2023]
Abstract
PURPOSE Caffeine is the most commonly used central nervous system (CNS) stimulant. The relationship between caffeine, seizures, epilepsy, and antiepileptic drugs (AEDs) is complex and not fully understood. Case reports suggest that caffeine triggers seizures in susceptible people. Our systematic review reports on the relationship between caffeine, seizures, and drugs in animal and human studies. Quantitative analyses were also done on animal studies regarding the effects of caffeine on AEDs. METHODS PubMed was searched for studies assessing the effects of caffeine on seizure susceptibility, epilepsy, and drug interactions in people and in animal models. To quantify the interaction between AEDs and caffeine, the data of six animal studies were pooled and analyzed using a general linear model univariate analysis or One-way Analysis of Variance (ANOVA). RESULTS In total, 442 items were identified from which we included 105 studies. Caffeine can increase seizure susceptibility and protect from seizures, depending on the dose, administration type (chronic or acute), and the developmental stage at which caffeine exposure started. In animal studies, caffeine decreased the antiepileptic potency of some drugs; this effect was strongest in topiramate. CONCLUSION Preclinical studies suggest that caffeine increases seizure susceptibility. In some cases, chronic use of caffeine may protect against seizures. Caffeine lowers the efficacy of several drugs, especially topiramate. It is unclear how these findings in models can be translated to the clinical condition. Until clinical studies suggest otherwise, caffeine intake should be considered as a factor in achieving and maintaining seizure control in epilepsy.
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Affiliation(s)
- Rick R van Koert
- Health, Medical and Neuropsychology Unit, Institute of Psychology, Leiden University, Leiden, The Netherlands
| | - Prisca R Bauer
- Stichting Epilepsie Instellingen Nederland (SEIN), Heemstede, The Netherlands; NIHR University College London Hospitals Biomedical Research Centre, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK
| | - Ilse Schuitema
- Health, Medical and Neuropsychology Unit, Institute of Psychology, Leiden University, Leiden, The Netherlands
| | - Josemir W Sander
- Stichting Epilepsie Instellingen Nederland (SEIN), Heemstede, The Netherlands; NIHR University College London Hospitals Biomedical Research Centre, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK; Chalfont Centre for Epilepsy, Chalfont St Peter, UK.
| | - Gerhard H Visser
- Stichting Epilepsie Instellingen Nederland (SEIN), Heemstede, The Netherlands
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Kerkhofs A, Xavier AC, da Silva BS, Canas PM, Idema S, Baayen JC, Ferreira SG, Cunha RA, Mansvelder HD. Caffeine Controls Glutamatergic Synaptic Transmission and Pyramidal Neuron Excitability in Human Neocortex. Front Pharmacol 2018; 8:899. [PMID: 29354052 PMCID: PMC5758559 DOI: 10.3389/fphar.2017.00899] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2017] [Accepted: 11/27/2017] [Indexed: 12/13/2022] Open
Abstract
Caffeine is the most widely used psychoactive drug, bolstering attention and normalizing mood and cognition, all functions involving cerebral cortical circuits. Whereas studies in rodents showed that caffeine acts through the antagonism of inhibitory A1 adenosine receptors (A1R), neither the role of A1R nor the impact of caffeine on human cortical neurons is known. We here provide the first characterization of the impact of realistic concentrations of caffeine experienced by moderate coffee drinkers (50 μM) on excitability of pyramidal neurons and excitatory synaptic transmission in the human temporal cortex. Moderate concentrations of caffeine disinhibited several of the inhibitory A1R-mediated effects of adenosine, similar to previous observations in the rodent brain. Thus, caffeine restored the adenosine-induced decrease of both intrinsic membrane excitability and excitatory synaptic transmission in the human pyramidal neurons through antagonism of post-synaptic A1R. Indeed, the A1R-mediated effects of endogenous adenosine were more efficient to inhibit synaptic transmission than neuronal excitability. This was associated with a distinct affinity of caffeine for synaptic versus extra-synaptic human cortical A1R, probably resulting from a different molecular organization of A1R in human cortical synapses. These findings constitute the first neurophysiological description of the impact of caffeine on pyramidal neuron excitability and excitatory synaptic transmission in the human temporal cortex, providing adequate ground for the effects of caffeine on cognition in humans.
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Affiliation(s)
- Amber Kerkhofs
- Department of Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research, Neuroscience Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.,Center for Neuroscience and Cell Biology, University of Coimbra, Coimbra, Portugal
| | - Ana C Xavier
- Center for Neuroscience and Cell Biology, University of Coimbra, Coimbra, Portugal
| | - Beatriz S da Silva
- Portuguese National Institute of Legal Medicine and Forensic Sciences, Coimbra, Portugal
| | - Paula M Canas
- Center for Neuroscience and Cell Biology, University of Coimbra, Coimbra, Portugal
| | - Sander Idema
- Department of Neurosurgery, Neuroscience Amsterdam, VU University Medical Center Amsterdam, Amsterdam, Netherlands
| | - Johannes C Baayen
- Department of Neurosurgery, Neuroscience Amsterdam, VU University Medical Center Amsterdam, Amsterdam, Netherlands
| | - Samira G Ferreira
- Center for Neuroscience and Cell Biology, University of Coimbra, Coimbra, Portugal
| | - Rodrigo A Cunha
- Center for Neuroscience and Cell Biology, University of Coimbra, Coimbra, Portugal.,Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Huibert D Mansvelder
- Department of Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research, Neuroscience Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
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Samsonsen C, Sand T, Bråthen G, Helde G, Brodtkorb E. The impact of sleep loss on the facilitation of seizures: A prospective case-crossover study. Epilepsy Res 2016; 127:260-266. [PMID: 27665308 DOI: 10.1016/j.eplepsyres.2016.09.014] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Revised: 09/02/2016] [Accepted: 09/15/2016] [Indexed: 11/30/2022]
Abstract
PURPOSE The relationship between sleep and seizures is intricate. The aim of this study was to assess whether sleep loss is an independent seizure precipitant in a clinical setting. METHODS In this prospective, observational cross-over study, 179 consecutive hospital admissions for epileptic seizures were included. A semi-structured interview regarding several seizure precipitants was performed. The sleep pattern prior to the seizure, as well as alcohol, caffeine and drug use, were recorded. The interview was repeated by telephone covering the same weekday at a time when there had been no recent seizure. The Hospital Anxiety and Depression Scale (HADS) and a visual analogue scale for perceived stress were applied at admission. Student's t-test, Fisher exact test and ANOVA were used for statistical analyses. RESULTS Complete data for analysis were retrieved in 144 patients. The sleep-time during the 24h prior to the seizure was lower (7.3h) compared to follow-up (8.3h; p<0.0005). Caffeine consumption and use of relevant non antiepileptic drugs (AED) were not different. HADS and stress scores at admission did not correlate with sleep-time difference. In ANOVA, controlled for alcohol consumption and AED use, the sleep-time difference remained significant (p=0.008). The interaction with alcohol intake was high, but the sleep-time difference remained highly significant also for the non- and low-consumption (≤2 units per day) subgroup (n=121, 7.50h vs 8.42h, p=0.001). CONCLUSION Epileptic seizures are often precipitated by a combination of various clinical factors, but sleep loss stands out as an independent seizure trigger.
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Affiliation(s)
- Christian Samsonsen
- Department of Neurology and Clinical Neurophysiology, St. Olav's University Hospital, Trondheim, Norway; Department of Neuroscience, Faculty of Medicine, NTNU, Norwegian University of Science and Technology, Trondheim, Norway.
| | - Trond Sand
- Department of Neurology and Clinical Neurophysiology, St. Olav's University Hospital, Trondheim, Norway; Department of Neuroscience, Faculty of Medicine, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
| | - Geir Bråthen
- Department of Neurology and Clinical Neurophysiology, St. Olav's University Hospital, Trondheim, Norway; Department of Neuroscience, Faculty of Medicine, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
| | - Grethe Helde
- Department of Neuroscience, Faculty of Medicine, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
| | - Eylert Brodtkorb
- Department of Neurology and Clinical Neurophysiology, St. Olav's University Hospital, Trondheim, Norway; Department of Neuroscience, Faculty of Medicine, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
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Nehlig A. Effects of coffee/caffeine on brain health and disease: What should I tell my patients? Pract Neurol 2015; 16:89-95. [DOI: 10.1136/practneurol-2015-001162] [Citation(s) in RCA: 66] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/15/2015] [Indexed: 01/03/2023]
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Prevalence of Provocative Seizures in Persons with Epilepsy: A Longitudinal Study at Khon Kaen University Hospital, Thailand. Neurol Res Int 2015; 2015:659189. [PMID: 26640709 PMCID: PMC4660017 DOI: 10.1155/2015/659189] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Revised: 09/15/2015] [Accepted: 09/28/2015] [Indexed: 11/30/2022] Open
Abstract
Background and Objective. Provocative factors are one causative factor of seizure attacks in persons with epilepsy (PWE). There are limited data of prevalence and major provocative factors in Asian populations. Methods. This study was performed at the Epilepsy Clinic, Khon Kaen University Hospital. The patients who aged 15 years or over, who had been treated at least 3 months with at least one antiepileptic drug, and who were followed up for at least one year were included. Data of seizure control and triggers were collected retrospectively from medical records. Data analysis was performed to identify independent provocative factors. Results. A total of 382 PWE met the study criteria. The mean age was 40.4 ± 0.8 years. Approximately 44% of the patients had at least one provocative factor. By multivariate analysis, the independent provocative factors with the first three highest adjusted odds ratios were sleep deprivation (adjusted OR = 8.64, 95% CI 3.73–19.99), alcohol consumption (adjusted OR = 6.76, 95% CI 1.44–31.78), and feeling stressful (adjusted OR = 2.97, 95% CI 1.29–6.86). Conclusion. Almost half of seizure attacks may be caused by provocative factors in Thai PWEs and some factors may be preventable. Avoidance of these factors should be emphasized to epilepsy patients for improving clinical outcomes and quality of life.
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Germé K, Faure JB, Koning E, Nehlig A. Effect of caffeine and adenosine receptor ligands on the expression of spike-and-wave discharges in Genetic Absence Epilepsy Rats from Strasbourg (GAERS). Epilepsy Res 2015; 110:105-14. [DOI: 10.1016/j.eplepsyres.2014.11.022] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Revised: 11/20/2014] [Accepted: 11/28/2014] [Indexed: 11/28/2022]
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Chrościńska-Krawczyk M, Radzik I, Miziak B, Czuczwar SJ. Safety considerations for patients with epilepsy taking antiepileptic drugs alongside caffeine or other methylxanthine derivatives. Expert Opin Drug Metab Toxicol 2014; 10:981-9. [DOI: 10.1517/17425255.2014.920822] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Masino SA, Kawamura M, Ruskin DN. Adenosine receptors and epilepsy: current evidence and future potential. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2014; 119:233-55. [PMID: 25175969 PMCID: PMC6026023 DOI: 10.1016/b978-0-12-801022-8.00011-8] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Adenosine receptors are a powerful therapeutic target for regulating epileptic seizures. As a homeostatic bioenergetic network regulator, adenosine is perfectly suited to establish or restore an ongoing balance between excitation and inhibition, and its anticonvulsant efficacy is well established. There is evidence for the involvement of multiple adenosine receptor subtypes in epilepsy, but in particular the adenosine A1 receptor subtype can powerfully and bidirectionally regulate seizure activity. Mechanisms that regulate adenosine itself are increasingly appreciated as targets to thus influence receptor activity and seizure propensity. Taken together, established evidence for the powerful potential of adenosine-based epilepsy therapies and new strategies to influence receptor activity can combine to capitalize on this endogenous homeostatic neuromodulator.
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Affiliation(s)
- Susan A Masino
- Department of Psychology and Neuroscience Program, Trinity College, Hartford, Connecticut, USA.
| | - Masahito Kawamura
- Department of Pharmacology, Jikei University School of Medicine, Minato-ku, Tokyo, Japan
| | - David N Ruskin
- Department of Psychology and Neuroscience Program, Trinity College, Hartford, Connecticut, USA
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