迷走神经刺激和抗发作药物的协同作用
Yaroslav Winter1,2, Katharina Sandner3, Martin Glaser4
1Department of Neurology, Mainz Comprehensive Epilepsy and Sleep Medicine Center, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstr 1, 55131, Mainz, Germany. yaroslav.winter@unimedizin-mainz.de.
Journal of neurology
|June 27, 2023
概括
结合迷走神经刺激 (VNS) 和特定抗发作药物 (ASM),如SV2A调节剂或缓慢的通道抑制剂,可显著改善患者的控制. 与其他ASM类型相比,这种组合疗法提供了更好的反应率和发作自由度.
科学领域:
- 神经学 神经学
- 药理学 药理学是指药理学的学科.
- 医疗器械 医疗器械
背景情况:
- 神经刺激 (VNS) 是一种被公认的治疗发作的非药物治疗方法.
- 需要进一步研究VNS与抗发作药物 (ASM) 的最佳组合.
- 了解协同效应可以增强管理.
研究的目的:
- 确定VNS和各种ASM之间的协同效应.
- 为了评估VNS与不同ASM类结合的疗效.
- 为了确定VNS治疗的最佳ASM组合.
主要方法:
- 在151名患有VNS植入物和稳定的ASM治疗的患者中进行了观察性研究.
- 在VNS植入后2年内从迈因茨病登记处收集的数据.
- 通过应答率 (≥50%的发作减少) 和发作自由度来评估有效性.
主要成果:
- 总体响应率为50.3%,自由率为13.9%.
- 与SV2A调节剂 (64.0%的响应率,19.8%的发作自由) 或缓慢道抑制剂 (61.8%的响应率,19.7%的发作自由) 结合使用VNS显示出明显更好的结果.
- 布里瓦拉塞坦比 levetiracetam 更有效; 拉科萨米德和埃斯利卡巴泽平在其组内表现出类似的效果.
结论:
- 与SV2A调节器或缓慢通道抑制剂相结合的VNS可能是控制发作的最佳选择.
- 这些ASM增强了VNS在治疗中的疗效.
- 需要进一步的受控研究来验证这些发现.
相关概念视频
01:20Antiepileptic Drugs: Modulators of Neurotransmitter Release Mediated by SV2A Protein
351
Antiepileptic drugs, such as levetiracetam (Keppra) and brivaracetam (Briviact), have emerged as crucial tools in managing epilepsy. These medications exert their therapeutic effects by targeting the synaptic vesicle protein SV2A, a transmembrane glycoprotein primarily found in the brain.
SV2A is a transmembrane glycoprotein located predominantly in the brain, modulating the release of neurotransmitters for neuronal communication. Both levetiracetam and brivaracetam exhibit a high affinity for...
SV2A is a transmembrane glycoprotein located predominantly in the brain, modulating the release of neurotransmitters for neuronal communication. Both levetiracetam and brivaracetam exhibit a high affinity for...
351
01:18Antiepileptic Drugs: GABAergic Pathway Potentiators
467
γ-aminobutyric acid or GABA, plays a pivotal role as an inhibitory neurotransmitter in the brain. GABA pathway potentiators, also known as GABAergic drugs, are a class of pharmaceutical agents designed to enhance the functioning of the GABAergic system. These medications primarily treat epilepsy, a neurological disorder characterized by recurrent seizures.
The key GABA pathway potentiators used in epilepsy management are as follows.
Benzodiazepines are a well-known class of drugs used for...
The key GABA pathway potentiators used in epilepsy management are as follows.
Benzodiazepines are a well-known class of drugs used for...
467
01:20Antiepileptic Drugs: Potassium Channel Activators
217
Ezocgabine or retigabine, an antiepileptic drug of remarkable efficacy, has revolutionized the management of seizures. It is a potassium channel activator, explicitly targeting the family of Q subtype potassium channels. It enhances the transmembrane potassium currents, regulating neuronal excitability. This action stabilizes the resting membrane potential, a pivotal factor in mitigating the hyperexcitability that characterizes epilepsy.
Ezogabine has gained approval as an adjunctive treatment...
Ezogabine has gained approval as an adjunctive treatment...
217
01:08Antiepileptic Drugs: Sodium Channel Blockers
690
Antiepileptic drugs are specialized medications that prevent seizures in individuals diagnosed with epilepsy. These drugs primarily function by blocking the movement of sodium ions through channels in the neuronal membrane, inhibiting the repetitive firing of action potentials often associated with seizures.
Sodium channel blockers modulate ion channels, particularly voltage-gated sodium channels. They block only sodium ion movement.
Among the most commonly prescribed antiepileptic drugs are...
Sodium channel blockers modulate ion channels, particularly voltage-gated sodium channels. They block only sodium ion movement.
Among the most commonly prescribed antiepileptic drugs are...
690
01:24Epilepsy and Seizures: Overview
228
Epilepsy is a chronic neurological disease marked by recurrent, unpredictable seizures. These seizures are caused by abnormal electrical discharges in the brain, leading to behavior, sensation, or consciousness alterations. They can also cause transient impairment of awareness, interfering with daily activities.
Various factors can trigger epilepsy, including genetic factors, brain damage, metabolic causes, and unknown etiology. Diagnosis of epilepsy involves electroencephalography (EEG), which...
Various factors can trigger epilepsy, including genetic factors, brain damage, metabolic causes, and unknown etiology. Diagnosis of epilepsy involves electroencephalography (EEG), which...
228
01:14Antiepileptic Drugs: Glutamate Antagonists
429
Glutamate is a fundamental neurotransmitter in the central nervous system, playing a vital role in neuronal communication and various cognitive processes. Glutamate stands as the principal excitatory neurotransmitter in the brain. Its presence is crucial for the communication between neurons, underpinning essential processes such as synaptic transmission, neuronal excitability, and plasticity. These functions are vital for higher-order cognitive processes, including learning and memory. The...
429