1
|
Aghamiri H, Jafari-Sabet M, Hoormand M. Ameliorative Effect of Cannabidiol on Topiramate-Induced Memory Loss: The Role of Hippocampal and Prefrontal Cortical NMDA Receptors and CREB/BDNF Signaling Pathways in Rats. Neurochem Res 2024; 49:363-378. [PMID: 37814133 DOI: 10.1007/s11064-023-04041-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 09/23/2023] [Accepted: 09/26/2023] [Indexed: 10/11/2023]
Abstract
Cannabidiol (CBD) is a promising neurological agent with potential beneficial effects on memory and cognitive function. The combination of CBD and topiramate in the treatment of some neurological diseases has been of great interest. Since Topiramate-induced memory loss is a major drawback of its clinical application and the overall effect of the combination of CBD and topiramate on memory is still unclear, here we investigated the effect of CBD on topiramate-induced memory loss and the underlying molecular mechanisms. A one trial step-through inhibitory test was used to evaluate memory consolidation in rats. Moreover, the role of N-methyl-D-aspartate receptors (NMDARs) in the combination of CBD and topiramate in memory consolidation was evaluated through the intra-CA1 administration of MK-801 and NMDA. Western blot analysis was used to evaluate variations in brain-derived neurotrophic factor (BDNF) and phosphorylated cyclic AMP response element-binding protein (pCREB)/CREB ratio in the prefrontal cortex (PFC) and hippocampus (HPC). While the intraperitoneal (i.p.) administration of topiramate (50, 75, and 100 mg/kg) significantly reduced inhibitory time latency, the i.p. administration of CBD (20 and 40 mg/kg) could effectively reverse these effects. Similarly, the sub-effective doses of NMDA plus CBD (10 mg/kg) could improve the topiramate-induced memory loss along with an enhancement in BDNF and pCREB expression in the PFC and HPC. Contrarily, the administration of sub-effective doses of the NMDAR antagonist (MK-801) diminished the protective effects of CBD (20 mg/kg) on topiramate-induced memory loss associated with decreased BDNF and pCREB levels in the PFC and HPC. These findings suggest that CBD can improve topiramate-induced memory impairment, partially by the NMDARs of the PFC and HPC, possibly regulated by the CREB/BDNF signaling pathway.
Collapse
Affiliation(s)
- Helia Aghamiri
- Department of Pharmacology, School of Medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Majid Jafari-Sabet
- Department of Pharmacology, School of Medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran.
- Razi Drug Research Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
| | - Mahmood Hoormand
- Department of Pharmacology, School of Medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran
- Razi Drug Research Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
2
|
Wang SJ, Zhao MY, Zhao PC, Zhang W, Rao GW. Research Status, Synthesis and Clinical Application of Antiepileptic Drugs. Curr Med Chem 2024; 31:410-452. [PMID: 36650655 DOI: 10.2174/0929867330666230117160632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 10/25/2022] [Accepted: 11/03/2022] [Indexed: 01/19/2023]
Abstract
According to the 2017 ILAE's official definition, epilepsy is a slow brain disease state characterized by recurrent episodes. Due to information released by ILAE in 2017, it can be divided into four types, including focal epilepsy, generalized epilepsy, combined generalized, and focal epilepsy, and unknown epilepsy. Since 1989, 24 new antiepileptic drugs have been approved to treat different types of epilepsy. Besides, there are a variety of antiepileptic medications under clinical monitoring. These novel antiepileptic drugs have plenty of advantages. Over the past 33 years, there have been many antiepileptic drugs on the mearket, but no one has been found that can completely cure epilepsy. In this paper, the mentioned drugs were classified according to their targets, and the essential information, and clinical studies of each drug were described. The structure-activity relationship of different chemical structures was summarized. This paper provides help for the follow-up research on epilepsy drugs.
Collapse
Affiliation(s)
- Si-Jie Wang
- College of Pharmaceutical Science, Institute of Drug Development & Chemical Biology, Zhejiang University of Technology, Hangzhou 310014, P.R. China
| | - Min-Yan Zhao
- College of Pharmaceutical Science, Institute of Drug Development & Chemical Biology, Zhejiang University of Technology, Hangzhou 310014, P.R. China
| | - Peng-Cheng Zhao
- College of Pharmaceutical Science, Institute of Drug Development & Chemical Biology, Zhejiang University of Technology, Hangzhou 310014, P.R. China
| | - Wen Zhang
- College of Pharmaceutical Science, Institute of Drug Development & Chemical Biology, Zhejiang University of Technology, Hangzhou 310014, P.R. China
| | - Guo-Wu Rao
- College of Pharmaceutical Science, Institute of Drug Development & Chemical Biology, Zhejiang University of Technology, Hangzhou 310014, P.R. China
| |
Collapse
|
3
|
Mokrov GV, Biryukova VE, Vorobieva TY, Pantileev AS, Grigorkevich OS, Zhmurenko LA, Rebeko AG, Bayburtskiy FS, Litvinova SA, Voronina TA, Gudasheva TA, Seredenin SB. Design, Synthesis and Anticonvulsant Activity of Cinnamoyl Derivatives of 3,4,6,7,8,9-hexahydrodibenzo[ b,d]furan-1-(2H)-one Oxime. Med Chem 2024; 20:92-107. [PMID: 37694795 DOI: 10.2174/1573406419666230908121759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 06/14/2023] [Accepted: 06/27/2023] [Indexed: 09/12/2023]
Abstract
BACKGROUND Epilepsy continues to be a significant global health problem and the search for new drugs for its treatment remains an urgent task. 5-HT2 and GABAA-receptors are among promising biotargets for the search for new anticonvulsants. METHODS New potential 5-HT2 and GABAA ligands in the series of substituted cinnamoyl derivatives of 3,4,6,7,8,9-hexahydrodibenzo[b,d]furan-1-(2H)-one oxime were designed using pharmacophore model and molecular docking analysis. The synthesis of new compounds was carried out from 3,4,6,7,8,9-hexahydrodibenzo[b,d]furan-1(2H)-one oxime and substituted cinnamoyl chlorides. The anticonvulsant activity of new substances has been established using the maximal electroshock seizure test. RESULTS Several synthesized substituted cinnamoyl derivatives of 3,4,6,7,8,9-hexahydrodibenzo [b,d]furan-1-(2H)-one oxime significantly reduced the severity of convulsive manifestations and completely prevented the death of animals after MES. The structure-activity relationship was investigated. The most effective compound was found to be GIZH-348 (1g) (3,4,6,7,8,9-hexahydrodibenzo[ b,d]furan-1(2Н)-one О-(4-chlorophenyl)acryloyl)oxime) at the doses of 10-20 mg/kg. CONCLUSION Molecular and pharmacophore modelling methods allowed us to create a new group of substituted cinnamoyl derivatives of 3,4,6,7,8,9-hexahydrodibenzo[b,d]furan-1-(2H)-one oxime with anticonvulsant activity.
Collapse
Affiliation(s)
- Grigory V Mokrov
- Department of Medicinal Chemistry, FSBI Zakusov Research Institute of Pharmacology, Baltiyskaya 8, Moscow, 125315 Russia
| | - Valentina E Biryukova
- Department of Medicinal Chemistry, FSBI Zakusov Research Institute of Pharmacology, Baltiyskaya 8, Moscow, 125315 Russia
| | - Tatiana Y Vorobieva
- Department of Medicinal Chemistry, FSBI Zakusov Research Institute of Pharmacology, Baltiyskaya 8, Moscow, 125315 Russia
| | - Andry S Pantileev
- Department of Medicinal Chemistry, FSBI Zakusov Research Institute of Pharmacology, Baltiyskaya 8, Moscow, 125315 Russia
| | - Oksana S Grigorkevich
- Department of Medicinal Chemistry, FSBI Zakusov Research Institute of Pharmacology, Baltiyskaya 8, Moscow, 125315 Russia
| | - Ludmila A Zhmurenko
- Department of Medicinal Chemistry, FSBI Zakusov Research Institute of Pharmacology, Baltiyskaya 8, Moscow, 125315 Russia
| | - Alexey G Rebeko
- Department of Medicinal Chemistry, FSBI Zakusov Research Institute of Pharmacology, Baltiyskaya 8, Moscow, 125315 Russia
| | - Felix S Bayburtskiy
- Department of Medicinal Chemistry, FSBI Zakusov Research Institute of Pharmacology, Baltiyskaya 8, Moscow, 125315 Russia
| | - Svetlana A Litvinova
- Department of Medicinal Chemistry, FSBI Zakusov Research Institute of Pharmacology, Baltiyskaya 8, Moscow, 125315 Russia
| | - Tatiana A Voronina
- Department of Medicinal Chemistry, FSBI Zakusov Research Institute of Pharmacology, Baltiyskaya 8, Moscow, 125315 Russia
| | - Tatiana A Gudasheva
- Department of Medicinal Chemistry, FSBI Zakusov Research Institute of Pharmacology, Baltiyskaya 8, Moscow, 125315 Russia
| | - Sergei B Seredenin
- Department of Medicinal Chemistry, FSBI Zakusov Research Institute of Pharmacology, Baltiyskaya 8, Moscow, 125315 Russia
| |
Collapse
|
4
|
Shrestha A, Wood EL, Berrios-Siervo G, Stredny CM, Boyer K, Vega C, Nangia S, Muscal E, Eschbach K. Long-term neuropsychological outcomes in children with febrile infection-related epilepsy syndrome (FIRES) treated with anakinra. Front Neurol 2023; 14:1100551. [PMID: 36970506 PMCID: PMC10030614 DOI: 10.3389/fneur.2023.1100551] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 02/13/2023] [Indexed: 03/29/2023] Open
Abstract
Background Febrile-infection related epilepsy syndrome (FIRES) is a rare epilepsy syndrome in which a previously healthy individual develops refractory status epilepticus in the setting of a preceding febrile illness. There are limited data regarding detailed long-term outcomes. This study aims to describe the long-term neuropsychological outcomes in a series of pediatric patients with FIRES. Methods This is a retrospective multi-center case series of pediatric patients with a diagnosis of FIRES treated acutely with anakinra who had neuropsychological testing at least 12 months after status epilepticus onset. Each patient underwent comprehensive neuropsychological evaluation as part of routine clinical care. Additional data collection included the acute seizure presentation, medication exposures, and outcomes. Results There were six patients identified with a median age of 11.08 years (IQR: 8.19-11.23) at status epilepticus onset. Anakinra initiation was a median of 11 days (IQR: 9.25-13.50) after hospital admission. All patients had ongoing seizures and none of the patients returned to baseline cognitive function with a median follow-up of 40 months (IQR 35-51). Of the five patients with serial full-scale IQ testing, three demonstrated a decline in scores over time. Testing results revealed a diffuse pattern of deficits across domains and all patients required special education and/or accommodations for academic learning. Conclusions Despite treatment with anakinra, neuropsychological outcomes in this series of pediatric patients with FIRES demonstrated ongoing diffuse neurocognitive impairment. Future research will need to explore the predictors of long-term neurocognitive outcomes in patients with FIRES and to evaluate if acute treatment interventions improve these outcomes.
Collapse
Affiliation(s)
- Anima Shrestha
- University of Colorado School of Medicine, Aurora, CO, United States
| | - E. Lynne Wood
- Department of Pediatrics, Section of Neurology, University of Colorado School of Medicine, Children's Hospital Colorado, Aurora, CO, United States
| | - Gretchen Berrios-Siervo
- Department of Pediatrics, Section of Neurology, University of Colorado School of Medicine, Children's Hospital Colorado, Aurora, CO, United States
- Department of Pediatrics, University of Colorado School of Medicine, Children's Hospital Colorado, Aurora, CO, United States
| | - Coral M. Stredny
- Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Boston, MA, United States
- Program in Neuroimmunology, Department of Neurology, Boston Children's Hospital, Boston, MA, United States
| | - Katrina Boyer
- Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Boston, MA, United States
| | - Clemente Vega
- Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Boston, MA, United States
| | - Srishti Nangia
- Department of Child Neurology, Weill Cornell Medicine, New York-Presbyterian Hospital, New York, NY, United States
| | - Eyal Muscal
- Department of Pediatrics and Child Neurology (Co-appointment), Baylor College of Medicine, Houston, TX, United States
| | - Krista Eschbach
- Department of Pediatrics, Section of Neurology, University of Colorado School of Medicine, Children's Hospital Colorado, Aurora, CO, United States
- *Correspondence: Krista Eschbach
| |
Collapse
|
5
|
Strzelczyk A, Schubert-Bast S. Psychobehavioural and Cognitive Adverse Events of Anti-Seizure Medications for the Treatment of Developmental and Epileptic Encephalopathies. CNS Drugs 2022; 36:1079-1111. [PMID: 36194365 PMCID: PMC9531646 DOI: 10.1007/s40263-022-00955-9] [Citation(s) in RCA: 37] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/07/2022] [Indexed: 02/06/2023]
Abstract
The developmental and epileptic encephalopathies encompass a group of rare syndromes characterised by severe drug-resistant epilepsy with onset in childhood and significant neurodevelopmental comorbidities. The latter include intellectual disability, developmental delay, behavioural problems including attention-deficit hyperactivity disorder and autism spectrum disorder, psychiatric problems including anxiety and depression, speech impairment and sleep problems. Classical examples of developmental and epileptic encephalopathies include Dravet syndrome, Lennox-Gastaut syndrome and tuberous sclerosis complex. The mainstay of treatment is with multiple anti-seizure medications (ASMs); however, the ASMs themselves can be associated with psychobehavioural adverse events, and effects (negative or positive) on cognition and sleep. We have performed a targeted literature review of ASMs commonly used in the treatment of developmental and epileptic encephalopathies to discuss the latest evidence on their effects on behaviour, mood, cognition, sedation and sleep. The ASMs include valproate (VPA), clobazam, topiramate (TPM), cannabidiol (CBD), fenfluramine (FFA), levetiracetam (LEV), brivaracetam (BRV), zonisamide (ZNS), perampanel (PER), ethosuximide, stiripentol, lamotrigine (LTG), rufinamide, vigabatrin, lacosamide (LCM) and everolimus. Bromide, felbamate and other sodium channel ASMs are discussed briefly. Overall, the current evidence suggest that LEV, PER and to a lesser extent BRV are associated with psychobehavioural adverse events including aggressiveness and irritability; TPM and to a lesser extent ZNS are associated with language impairment and cognitive dulling/memory problems. Patients with a history of behavioural and psychiatric comorbidities may be more at risk of developing psychobehavioural adverse events. Topiramate and ZNS may be associated with negative effects in some aspects of cognition; CBD, FFA, LEV, BRV and LTG may have some positive effects, while the remaining ASMs do not appear to have a detrimental effect. All the ASMs are associated with sedation to a certain extent, which is pronounced during uptitration. Cannabidiol, PER and pregabalin may be associated with improvements in sleep, LTG is associated with insomnia, while VPA, TPM, LEV, ZNS and LCM do not appear to have detrimental effects. There was variability in the extent of evidence for each ASM: for many first-generation and some second-generation ASMs, there is scant documented evidence; however, their extensive use suggests favourable tolerability and safety (e.g. VPA); second-generation and some third-generation ASMs tend to have the most robust evidence documented over several years of use (TPM, LEV, PER, ZNS, BRV), while evidence is still being generated for newer ASMs such as CBD and FFA. Finally, we discuss how a variety of factors can affect mood, behaviour and cognition, and untangling the associations between the effects of the underlying syndrome and those of the ASMs can be challenging. In particular, there is enormous heterogeneity in cognitive, behavioural and developmental impairments that is complex and can change naturally over time; there is a lack of standardised instruments for evaluating these outcomes in developmental and epileptic encephalopathies, with a reliance on subjective evaluations by proxy (caregivers); and treatment regimes are complex involving multiple ASMs as well as other drugs.
Collapse
Affiliation(s)
- Adam Strzelczyk
- Epilepsy Center Frankfurt Rhine-Main, Center of Neurology and Neurosurgery, Goethe-University and University Hospital Frankfurt, Schleusenweg 2-16, 60528, Frankfurt am Main, Germany. .,LOEWE Center for Personalized and Translational Epilepsy Research (CePTER), Goethe-University Frankfurt, Frankfurt am Main, Germany.
| | - Susanne Schubert-Bast
- Epilepsy Center Frankfurt Rhine-Main, Center of Neurology and Neurosurgery, Goethe-University and University Hospital Frankfurt, Schleusenweg 2-16, 60528, Frankfurt am Main, Germany.,LOEWE Center for Personalized and Translational Epilepsy Research (CePTER), Goethe-University Frankfurt, Frankfurt am Main, Germany.,Department of Neuropediatrics, Goethe-University and University Hospital Frankfurt, Frankfurt am Main, Germany
| |
Collapse
|
6
|
Kelly N, Kilmartin A, Lannon K, Lee C, McLoughlin R, Mulvanny L, Mohamed O, Treacy M, Rossi K, O'Connell J. Rating scales to measure adverse effects of medications in people with intellectual disability: a scoping review. Eur J Clin Pharmacol 2022; 78:1711-1725. [PMID: 36042024 PMCID: PMC9546988 DOI: 10.1007/s00228-022-03375-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 08/17/2022] [Indexed: 11/25/2022]
Abstract
Purpose Intellectual disability (ID) is a chronic neurodevelopmental condition characterised by limitations in intelligence and adaptive skills with an onset prior to the age of 18 years. People with ID have complex healthcare needs and are more likely than the general population to experience multiple comorbidities and polypharmacy, with subsequent increased risk of adverse medication effects. The aim of this scoping review is to characterise rating scales used to measure adverse effects of medication in people with ID. Methods Four online databases (PsycINFO, Medline, Web of Science and OpenGrey) were searched in April 2020. Studies were assessed for inclusion against pre-specified eligibility criteria. Reference lists of included studies were hand searched. Data extraction was carried out by two independent reviewers and key findings were tabulated for consideration. Studies were assessed for quality using the Mixed Methods Appraisal Tool. Results The search resulted in 512 unique records, of which fifteen met the inclusion criteria. Fourteen scales were identified. All scales assessed adverse effects of psychotropics only. Of the scales, only one, the Matson Evaluation of Drug Side Effects, which focuses on psychotropic medications, was originally developed for use in a population with ID. Conclusion The Matson Evaluation of Drug Side Effects scale appears to be the most reliable and well-researched scale in people with ID. However, a scale which measures adverse effects across multiple medication classes would be valuable for use in this population. Supplementary Information The online version contains supplementary material available at 10.1007/s00228-022-03375-2.
Collapse
Affiliation(s)
- Neasa Kelly
- School of Pharmacy & Pharmaceutical Sciences, Trinity College, Dublin, Ireland
| | - Andrew Kilmartin
- School of Pharmacy & Pharmaceutical Sciences, Trinity College, Dublin, Ireland
| | - Kevin Lannon
- School of Pharmacy & Pharmaceutical Sciences, Trinity College, Dublin, Ireland
| | - Caren Lee
- School of Pharmacy & Pharmaceutical Sciences, Trinity College, Dublin, Ireland
| | - Rory McLoughlin
- School of Pharmacy & Pharmaceutical Sciences, Trinity College, Dublin, Ireland
| | - Lara Mulvanny
- School of Pharmacy & Pharmaceutical Sciences, Trinity College, Dublin, Ireland
| | - Omnyiah Mohamed
- School of Pharmacy & Pharmaceutical Sciences, Trinity College, Dublin, Ireland
| | - Mairead Treacy
- School of Pharmacy & Pharmaceutical Sciences, Trinity College, Dublin, Ireland
| | - Karen Rossi
- School of Pharmacy & Pharmaceutical Sciences, Trinity College, Dublin, Ireland
| | - Juliette O'Connell
- School of Pharmacy & Pharmaceutical Sciences, Trinity College, Dublin, Ireland.
| |
Collapse
|
7
|
Aydin S, Yazici ZG, Kilic C, Ercelen Ozozturk B, Kilic FS. An overview of the behavioral, neurobiological and morphological effects of topiramate in rats exposed to chronic unpredictable mild stress. Eur J Pharmacol 2021; 912:174578. [PMID: 34695423 DOI: 10.1016/j.ejphar.2021.174578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 10/07/2021] [Accepted: 10/18/2021] [Indexed: 10/20/2022]
Abstract
The environmental psychological stress causes depressive disorders. Stress causes many neurobiological, neurodegenerative changes in brain. Topiramate (TPM) is used in the treatment of epilepsy and psychiatric diseases. However, there are conflicting findings that TPM disrupts cognitive functions. We aimed to investigate the effects of TPM on depression, anxiety, learning and memory as well as neurobiological, morphological changes in rats exposed to chronic unpredictable mild stress (CUMS). After CUMS was formed by random application of nine mild stressors for 45 days, TPM (at doses of 0.1, 1, 10, 100 mg/kg) was administered for 21 days. Sucrose preference, locomotor activity, forced swimming, elevated plus maze and Morris water maze tests were performed. Corticosterone, BDNF (Brain-derived neurotrophic factor) and glutamate levels and volumes of hippocampus were evaluated. Body weights of the rats were measured. Immobilization time increased in CUMS, CUMS + TPM0.1 in forced swimming test and time spent in platform quadrant increased in Control + TPM1, CUMS, CUMS + TPM0.1, CUMS + TPM1 in Morris water maze test. Control + TPM1 decreased distance to platform in Morris water maze while CUMS + TPM100 increased. Learning is impaired in CUMS + TPM100 while it is improved in Control + TPM1. BDNF levels increased in CUMS and glutamate levels increased in CUMS, CUMS + TPM10. Body weight decreased in CUMS, CUMS + TPM0.1, CUMS + TPM1, CUMS + TPM100. Hippocampus volumes increased in CUMS. In conclusion, CUMS improved cognition and this finding was supported by the increase of BDNF levels and volume of hippocampus. TPM 1 mg/kg improved cognition in non-stressed rats. TPM 0.1 and 1 mg/kg improved while TPM 100 mg/kg impaired memory in rats exposed to stress.
Collapse
Affiliation(s)
- Sule Aydin
- Eskisehir Osmangazi University, Faculty of Medicine, Department of Pharmacology, Meselik Kampusu, Eskisehir, Turkey.
| | - Zeynep Gul Yazici
- Eskisehir Osmangazi University, Faculty of Medicine, Department of Pharmacology, Meselik Kampusu, Eskisehir, Turkey.
| | - Cansu Kilic
- Eskisehir Osmangazi University, Faculty of Medicine, Department of Pharmacology, Meselik Kampusu, Eskisehir, Turkey.
| | | | - Fatma Sultan Kilic
- Eskisehir Osmangazi University, Faculty of Medicine, Department of Pharmacology, Meselik Kampusu, Eskisehir, Turkey.
| |
Collapse
|
8
|
Brandt C, Müffelmann B, May TW, Hopf JL, Ottenottebrock H, Endermann M, Thorbecke R, Bien CG. Effects of a specialized inpatient treatment program on epilepsy-related impairments of patients with epilepsy and intellectual disability as rated by relatives and professional caregivers. Epilepsy Behav 2021; 117:107809. [PMID: 33639437 DOI: 10.1016/j.yebeh.2021.107809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 01/18/2021] [Indexed: 11/26/2022]
Abstract
INTRODUCTION The aim of the study was to determine the impact of a comprehensive inpatient treatment program for persons with epilepsy and intellectual disability (ID) on the concerns of relatives and caregivers, quality of life (QoL), and global health and clinical aspects, assessed by a questionnaire for relatives and caregivers. METHODS We performed an open, controlled pre/post study in inpatients with epilepsy and ID or acquired brain damage treated for at least 14 days in a tertiary referral center for epilepsy. Questionnaires were administered to relatives/professional caregivers shortly before admission and 6 months after discharge for the treatment group (TG). The control group (CG) was recruited from the waiting list; questionnaires were answered at the time of application for treatment and 3-6 months later. The questionnaire was the GEOS-43G, the German version of the Glasgow Epilepsy Outcome Scale (GEOS-35), which was extended by eight additional questions from the GEOS-90. Furthermore, QoL, global health, and clinical aspects were assessed using a short questionnaire. Generalized estimation equations (GEEs) were used for statistical analyses. RESULTS One-hundred and eight subjects were evaluable in the TG, and 90 in the CG. Concerns about seizures, injuries/risks, medical treatment, diagnostic issues, and the GEOS-43G total score decreased significantly in the TG in contrast to the CG. For the TG, improvements were also significant for global QoL, global health, efficacy, tolerability of AEDs, and for seizure frequency. Caregivers reported larger improvements compared to relatives. CONCLUSION The evaluation of the relatives and caregivers in our study indicates that inpatient treatment in a specialized center with a dedicated multi-professional program led to significant improvements regarding the concerns of relatives or caregivers, and in the QoL and related aspects in persons with epilepsy and ID. This shows that specialized inpatient treatment may be helpful for persons with epilepsy and ID.
Collapse
Affiliation(s)
- Christian Brandt
- Bethel Epilepsy Center, Mara Hospital, Maraweg 21, 33617 Bielefeld, Germany.
| | - Birgitt Müffelmann
- Bethel Epilepsy Center, Mara Hospital, Maraweg 21, 33617 Bielefeld, Germany
| | - Theodor W May
- Bethel Evangelic Hospital, Kantensiek 11, 33617 Bielefeld, Germany
| | - Johanna L Hopf
- Bethel Epilepsy Center, Mara Hospital, Maraweg 21, 33617 Bielefeld, Germany
| | | | - Michael Endermann
- Bethel Foundation, Division Bethel.regional, Maraweg, 33617 Bielefeld, Germany
| | | | - Christian G Bien
- Bethel Epilepsy Center, Mara Hospital, Maraweg 21, 33617 Bielefeld, Germany
| |
Collapse
|
9
|
Schraegle WA, Young SR, Rettig EK, Payne AR, Wilson JK, Wedberg-Sivam EA, Titus JB. Improving Transitional Services for Adolescents and Young Adults with Epilepsy and Intellectual Disability. JOURNAL OF PEDIATRIC EPILEPSY 2020. [DOI: 10.1055/s-0040-1716915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
AbstractThe transition from pediatric to adult health care systems is challenging for many adolescents with epilepsy and their families, and those challenges are compounded for adolescents with comorbid intellectual disabilities and epilepsy (ID-E). Many traditional transition pathways to adult care are inadequate, as they fail to address important considerations unique to the ID-E population or are absent entirely. Poor organization of care during critical transition periods increases the risks of sudden unexpected death in epilepsy, suboptimal seizure control, inadequate management of comorbidities, and poor psychological and social outcomes. The literature lacks systematic studies on effective transition programs for this population. The present review provides an overview of the main themes important in care transitions for the ID-E population: (1) precise diagnosis and management of seizures; (2) mental health and medical comorbidities affecting care; (3) accessing behavioral, habilitative, legal, financial, and community resources; and (4) caretaker support. We propose a specific framework which includes targeted recommendations of minimum care standards for youth with ID-E transitioning to adult care.
Collapse
Affiliation(s)
- William A. Schraegle
- Department of Neurology, Dell Medical School, The University of Texas at Austin, Austin, Texas, United States
- Comprehensive Pediatric Epilepsy Center, UT Health Austin Pediatric Neurosciences at Dell Children's, Dell Children's Medical Center, Austin, Texas, United States
| | - Stephanie R. Young
- Department of Neurology, Dell Medical School, The University of Texas at Austin, Austin, Texas, United States
- Comprehensive Pediatric Epilepsy Center, UT Health Austin Pediatric Neurosciences at Dell Children's, Dell Children's Medical Center, Austin, Texas, United States
| | - Eman K. Rettig
- Department of Neurology, Dell Medical School, The University of Texas at Austin, Austin, Texas, United States
- Comprehensive Pediatric Epilepsy Center, UT Health Austin Pediatric Neurosciences at Dell Children's, Dell Children's Medical Center, Austin, Texas, United States
| | - Angie R. Payne
- Ascension Seton’s Comprehensive Epilepsy Program, Dell Seton Medical Center at The University of Texas, Austin, Texas, United States
| | - Janet K. Wilson
- Comprehensive Pediatric Epilepsy Center, UT Health Austin Pediatric Neurosciences at Dell Children's, Dell Children's Medical Center, Austin, Texas, United States
| | - Elizabeth A. Wedberg-Sivam
- Ascension Seton’s Comprehensive Epilepsy Program, Dell Seton Medical Center at The University of Texas, Austin, Texas, United States
| | - Jeffrey B. Titus
- Department of Neurology, Dell Medical School, The University of Texas at Austin, Austin, Texas, United States
- Comprehensive Pediatric Epilepsy Center, UT Health Austin Pediatric Neurosciences at Dell Children's, Dell Children's Medical Center, Austin, Texas, United States
| |
Collapse
|
10
|
Yıldız-Çoksan S, Aslan A, Çoksan S, Okuyaz Ç. Cognitive profile and academic achievement of children with absence epilepsy. Epilepsy Behav 2019; 95:95-99. [PMID: 31030079 DOI: 10.1016/j.yebeh.2019.04.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 03/19/2019] [Accepted: 04/02/2019] [Indexed: 11/16/2022]
Abstract
The main aim of this study was to examine the cognitive profile and academic achievement of children with absence epilepsy. It is investigated whether all scale intelligence score, intelligence subscale scores, and academic achievement of the children with absence epilepsy differed from healthy peers and Turkish norm values. Nineteen children with absence epilepsy and 19 healthy children participate in the study. The Wechsler Intelligence Scale for Children-IV (WISC-IV) is used to measure their intelligence scores. A teacher assessment form (Teacher's Report Form (TRF)) is obtained from the participants' teachers for the measurement of academic achievement, and the students' report cards are collected as an additional measure of it. Participants with absence epilepsy have significantly lower scores of total intelligence score (Mean (M) = 76.68, Standard Deviation (SD) = 25.18), verbal comprehension score (M = 81.68, SD = 25.29), perceptual reasoning score (M = 85.47, SD = 20.61), processing speed score (M = 77.95, SD = 18.61), and working memory (M = 83.74, SD = 19.04), which are measured by WISC-IV, than healthy peers (respectively M = 105.84, SD = 16.20; M = 105.47, SD = 18.12; M = 103.63, SD = 12.88; M = 104.05, SD = 12.98; M = 104.74, SD = 18.97) and norm values (M = 100, SD = 10). No difference is observed between the subscale scores of WISC-IV for within group with absence epilepsy. Moreover, they have lower Turkish language (M = 73.65, SD = 19.19) and mathematics (M = 76.26, SD = 22.29) grade report scores than healthy peers (respectively M = 90.76, SD = 12.01; M = 88.64, SD = 15.93). There is no difference between the two groups in terms of the academic achievement obtained from the TRF. It is necessary to support children with absence epilepsy academically. We analyzed whether the current pattern has changed by comparing the intelligent scores and academic achievement of children with absence epilepsy who have recovered after treatment with their healthy peers. In fact, there is no difference between the children with absence epilepsy who have recovered after treatment and their healthy peers in terms of total intelligence score and its subscale scores. Similarly, there is no difference between them in terms of mathematics score on their report. Only the difference in the score of Turkish language continues in the same direction.
Collapse
Affiliation(s)
- Serpil Yıldız-Çoksan
- Ankara University, Faculty of Health Sciences, Department of Child Development, Ankara, Turkey.
| | - Aslı Aslan
- Mersin University, Faculty of Arts and Sciences, Department of Psychology, Mersin, Turkey
| | - Sami Çoksan
- Middle East Technical University, Faculty of Arts and Sciences, Department of Psychology, Ankara, Turkey
| | - Çetin Okuyaz
- Mersin University, School of Medicine, Department of Pediatric Neurology, Mersin, Turkey
| |
Collapse
|
11
|
van den Berg L, de Weerd A, Reuvekamp M, Hagebeuk E, van der Meere J. Working memory in pediatric frontal lobe epilepsy. APPLIED NEUROPSYCHOLOGY-CHILD 2019; 10:101-110. [PMID: 31092008 DOI: 10.1080/21622965.2019.1611431] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Thirty-two children with frontal lobe epilepsy (FLE) were assessed using different working memory measures. In addition, parents and teachers completed the working memory scale of the Behavioral Rating Inventory of Executive Functioning (BRIEF) to assess the children's "daily life behavior." Results suggested minimal working memory deficits as assessed with performance-based measures. However, the BRIEF showed more working memory deficits suggesting that, on a daily life level, working memory problems seem to be associated with FLE. We discuss why the results of the performance-based measures are not consistent with results of the BRIEF.HighlightsParents as well as teachers report working memory dysfunction in daily life to the same extent.Performance based measures show minimal deficits of working memory.Correlation between working memory tasks and proxy measures are low.
Collapse
Affiliation(s)
- Lydia van den Berg
- Stichting Epilepsie Instellingen Nederland, Zwolle, Netherlands.,Faculteit Clinical and developmental neuropsychology, Faculty behavioral science, University of Groningen, Netherlands
| | - Al de Weerd
- Stichting Epilepsie Instellingen Nederland, Zwolle, Netherlands
| | | | | | - Jaap van der Meere
- Faculteit Clinical and developmental neuropsychology, Faculty behavioral science, University of Groningen, Netherlands
| |
Collapse
|
12
|
|
13
|
Goh KK, Chen CH, Lu ML. Topiramate mitigates weight gain in antipsychotic-treated patients with schizophrenia: meta-analysis of randomised controlled trials. Int J Psychiatry Clin Pract 2019; 23:14-32. [PMID: 29557263 DOI: 10.1080/13651501.2018.1449864] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Weight gain is one of the most challenging issues in patients with schizophrenia treated with antipsychotics. Several meta-analyses have been conducted to review the efficacy of topiramate in reducing weight, however, several issues regarding the methodology had arisen of which make the results remain ambiguous. METHODS We conducted a meta-analysis of randomised controlled trials about the use of topiramate in patients with schizophrenia for weight reduction. Ten double-blinded randomised placebo-controlled trials and seven open-label randomised controlled trials included 905 patients. RESULTS Patients treated with topiramate experienced a greater reduction in body weight and BMI. Patients in countries of the lower overweight population showed more significant BMI reduction. Besides, studies from the Middle East and South Asia showed the greatest effect in body weight change, followed by East Asia, then Europe/America. Topiramate group was outperformed control group with significant psychopathology improvement. No difference between two groups regarding the overall side effects. CONCLUSIONS Topiramate was significantly superior to control group in mitigating weight gain and psychopathology in antipsychotic-treated patients with schizophrenia. The effects of topiramate augmentation need further investigations in larger definitive studies using methodological rigor and thorough assessments.
Collapse
Affiliation(s)
- Kah Kheng Goh
- a Department of Psychiatry , Wan-Fang Hospital, Taipei Medical University , Taipei , Taiwan
| | - Chun-Hsin Chen
- a Department of Psychiatry , Wan-Fang Hospital, Taipei Medical University , Taipei , Taiwan.,b Department of Psychiatry , School of Medicine, College of Medicine, Taipei Medical University , Taipei , Taiwan
| | - Mong-Liang Lu
- a Department of Psychiatry , Wan-Fang Hospital, Taipei Medical University , Taipei , Taiwan.,b Department of Psychiatry , School of Medicine, College of Medicine, Taipei Medical University , Taipei , Taiwan
| |
Collapse
|
14
|
|
15
|
Vidaurre J, Twanow JDE. Attention Deficit Hyperactivity Disorder and Associated Cognitive Dysfunction in Pediatric Epilepsy. Semin Pediatr Neurol 2017; 24:282-291. [PMID: 29249508 DOI: 10.1016/j.spen.2017.10.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Attention deficit hyperactivity disorder (ADHD) is the most common neuropsychiatric comorbidity associated with childhood epilepsy, affecting about a third of children with epilepsy. In contrast, ADHD in the general population occurs in 4%-12% of school-aged children. The cause of this association remains unclear. It is likely that common mechanisms underlie the vulnerability for both executive deficits and epileptogenesis. There are characteristics unique to children with ADHD and epilepsy. The inattentive type of ADHD is more prevalent than the combined presentation in children with epilepsy, while the combined type is more common in the general population. Interestingly, there is an equal sex distribution of ADHD in patients with epilepsy, while in the general population, ADHD is 3-7 times more prevalent in boys. Specific features of ADHD seen in different epilepsy syndromes are frequently associated with executive deficits. Early screening of ADHD symptoms in children with epilepsy is essential, as timely interventions can improve academic and social function and outcomes. The mainstays of therapy include behavioral interventions and pharmacotherapy, with evidence demonstrating that stimulants are both safe and effective in children with ADHD and epilepsy.
Collapse
Affiliation(s)
- Jorge Vidaurre
- From the Pediatric Neurology-Epilepsy Division, Nationwide Children's Hospital, The Ohio State University, Columbus, OH.
| | - Jaime Dawn E Twanow
- From the Pediatric Neurology-Epilepsy Division, Nationwide Children's Hospital, The Ohio State University, Columbus, OH
| |
Collapse
|
16
|
Measurement of side effects of anti-epileptic drugs (AEDs) in adults with intellectual disability: A systematic review. Seizure 2017; 51:61-73. [DOI: 10.1016/j.seizure.2017.07.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Revised: 07/13/2017] [Accepted: 07/19/2017] [Indexed: 12/28/2022] Open
|
17
|
Moavero R, Santarone ME, Galasso C, Curatolo P. Cognitive and behavioral effects of new antiepileptic drugs in pediatric epilepsy. Brain Dev 2017; 39:464-469. [PMID: 28202262 DOI: 10.1016/j.braindev.2017.01.006] [Citation(s) in RCA: 78] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Revised: 12/28/2016] [Accepted: 01/16/2017] [Indexed: 01/31/2023]
Abstract
BACKGROUND In pediatric epilepsy, neurodevelopmental comorbidities could be sometimes even more disabling than seizures themselves, therefore it is crucial for the clinicians to understand how to benefit these children, and to choose the proper antiepileptic drug for the treatment of epilepsy associated to a specific neurodevelopmental disorder. Aim of this paper is to discuss the potential impact on cognition and behavior of new and newest AEDs and to guide the choice of the clinicians for a targeted use in epilepsy associated with specific neurodevelopmental disorders. METHODS Information in this review is mainly based on peer-reviewed medical publications from 2002 until October 2016 (PubMed). We choose to include in our review only the AEDs of second and third generation approved for pediatric population. RESULTS Vigabatrin, lamotrigine, topiramate, levetiracetam, oxcarbazepine, zonisamide, rufinamide, lacosamide, eslicarbazepine, and perampanel have been included in this review. The most tolerated AEDs from a cognitive and behavioral point of view are lamotrigine and rufinamide, thus representing optimal drugs for children with cognitive and/or attention problems. DISCUSSION Most of the new AEDs are initially licensed for adult patients. Data on children are usually very limited, both in terms of efficacy and safety, and the use standardized cognitive and behavioral outcome measures are very limited in pediatric clinical trials. CONCLUSION Several factors including polytherapy, administration of AEDs with the same mechanism of action and the dose and titration of the drug, should be considered as important in the development of cognitive and behavioral side effects.
Collapse
Affiliation(s)
- Romina Moavero
- Child Neurology and Psychiatry Unit, Tor Vergata University of Rome, Italy; Child Neurology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
| | | | - Cinzia Galasso
- Child Neurology and Psychiatry Unit, Tor Vergata University of Rome, Italy
| | - Paolo Curatolo
- Child Neurology and Psychiatry Unit, Tor Vergata University of Rome, Italy
| |
Collapse
|
18
|
Kerr M, Linehan C, Brandt C, Kanemoto K, Kawasaki J, Sugai K, Tadokoro Y, Villanueva V, Wilmshurst J, Wilson S. Behavioral disorder in people with an intellectual disability and epilepsy: A report of the Intellectual Disability Task Force of the Neuropsychiatric Commission of ILAE. Epilepsia Open 2016; 1:102-111. [PMID: 29588933 PMCID: PMC5719831 DOI: 10.1002/epi4.12018] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/16/2016] [Indexed: 11/25/2022] Open
Abstract
The management and needs of people with intellectual disability (ID) and epilepsy are well evidenced; less so, the comorbidity of behavioral disorder in this population. "Behavioral disorder" is defined as behaviors that are difficult or disruptive, including stereotypes, difficult or disruptive behavior, aggressive behavior toward other people, behaviors that lead to injury to self or others, and destruction of property. These have an important link to emotional disturbance. This report, produced by the Intellectual Disability Task Force of the Neuropsychiatric Commission of the ILAE, aims to provide a brief review of some key areas of concern regarding behavioral disorder among this population and proposes a range of research and clinical practice recommendations generated by task force members. The areas covered in this report were identified by experts in the field as being of specific relevance to the broad epilepsy community when considering behavioral disorder in persons with epilepsy and ID; they are not intended to be exhaustive. The practice recommendations are based on the authors' review of the limited research in this field combined with their experience supporting this population. These points are not graded but can be seen as expert opinion guiding future research and clinical practice.
Collapse
Affiliation(s)
- Mike Kerr
- Institute of Psychological Medicine and Clinical NeuroscienceCardiff UniversityCardiffUnited Kingdom
| | - Christine Linehan
- UCD Centre for Disability StudiesUniversity College DublinDublinIreland
- Tizard CentreUniversity of KentCanterburyUnited Kingdom
| | - Christian Brandt
- Department of General EpileptologyBethel Epilepsy CentreMara HospitalBielefeldGermany
| | | | | | - Kenji Sugai
- Department of Child NeurologyNational Center of Neurology and PsychiatryKodairaJapan
| | - Yukari Tadokoro
- Department of NeuropsychiatryAichi Medical UniversityAichiJapan
| | - Vicente Villanueva
- Multidisciplinary Epilepsy UnitNeurology ServiceUniversity Hospital and Polytechnic La FeValenciaSpain
| | - Jo Wilmshurst
- Department of Paediatric Neurology, Paediatrics and Child HealthRed Cross War Memorial Children's HospitalUniversity of Cape TownCape TownSouth Africa
| | - Sarah Wilson
- Melbourne School of Psychological Sciencesthe University of MelbourneMelbourneVictoriaAustralia
- Comprehensive Epilepsy ProgramAustin HealthMelbourneVictoriaAustralia
| |
Collapse
|
19
|
Brandt C, May TW, Bien CG. Brivaracetam as adjunctive therapy for the treatment of partial-onset seizures in patients with epilepsy: the current evidence base. Ther Adv Neurol Disord 2016; 9:474-482. [PMID: 27800023 DOI: 10.1177/1756285616665564] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Brivaracetam (BRV) is a novel antiepileptic drug recently licensed for the treatment of partial epilepsy in adults and adolescents over 16 years old. Like levetiracetam (LEV), it is a ligand of the synaptic vesicle protein SV2A. BRV has been shown in animal models and in studies using human brain slices to have a higher SV2A affinity and faster penetration into the brain. Its efficacy and safety have been shown in several randomized, controlled studies. The recommended initial dose is 50-100 mg, divided into two daily doses. Up-titration to a 200 mg daily dose is possible. Dizziness and somnolence are frequent side effects. There are some hints that BRV may be less frequently associated with behavioural adverse events than LEV. Long-term efficacy and safety and BRV use in special patient groups have to be assessed in the future.
Collapse
|
20
|
Valença MM. Commentary: Acute Tension-Type Headaches Are Associated with Impaired Cognitive Function and More Negative Mood. Front Neurol 2016; 7:103. [PMID: 27443409 PMCID: PMC4927582 DOI: 10.3389/fneur.2016.00103] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Accepted: 06/15/2016] [Indexed: 12/04/2022] Open
Affiliation(s)
- Marcelo M Valença
- Neurosurgery and Neurology Unit, Federal University of Pernambuco , Recife , Pernambuco, Brazil
| |
Collapse
|