Brain disorders (Amsterdam, Netherlands)最新文献_第3页

Neuroprotective effects of natural products against doxorubicin-induced chemobrain: a narrative review of preclinical animal studies 天然产物对阿霉素诱导的化学脑的神经保护作用：临床前动物研究的叙述性回顾

Brain disorders (Amsterdam, Netherlands)

Pub Date : 2025-09-16 DOI: 10.1016/j.dscb.2025.100284

Mehrnoush Vaez Salehy , Parvin Babaei , Zahra Nahavandi Ghaffarkandi , Foad Ghazizadeh

Rationale

Chemobrain/chemofog, or chemotherapy-related cognitive impairment (CRCI), is considered a prevalent long-term complication among survivors. Doxorubicin (DOX), a well-known anthracycline administered in various cancers, drew much attention regarding inducing animal chemobrain models. On the other hand, using natural compounds as a safe and promising strategy for mitigating many pathological conditions, including chemobrain, has become a trend.

Objectives

In this review, we focused on the reported neuroprotective effects of 16 naturally derived bioactives, including galangin, juglanin, rutin, quercetin, catechin, naringin, astaxanthin, polydatin, caffeic acid phenethyl ester, berberine, c-phycocyanin, omega-3 polyunsaturated fatty acids, alpha-lipoic acid, diosmin, thymoquinone, and curcumin against DOX-related cognitive deficit.

Results

Given the emphasis on learning, memory impairment, and exploratory behavior, our literature review suggests that reducing oxidative stress (OS), neuroinflammation, and apoptosis are core pathways. However, alterations in the levels of neurogenesis, synaptic plasticity, acetylcholine esterase (AChE) activity, and other less frequent processes such as autophagy, brain mitochondrial dysfunction, necroptosis, and nitrogenic stress have also been reported.

Conclusion

Beyond the value of the published studies, there is still an urgent need for further research to evaluate natural compounds around this phenomenon with additional mimicking of the clinical settings, using novel formulations, and investigating the new insights into the mechanisms involved.

化疗脑/化疗雾，或化疗相关认知障碍（CRCI），被认为是幸存者中普遍存在的长期并发症。多柔比星（DOX）是一种众所周知的蒽环类药物，用于治疗各种癌症，在诱导动物化学脑模型方面引起了广泛关注。另一方面，使用天然化合物作为一种安全而有前景的策略来减轻许多病理状况，包括化学脑，已经成为一种趋势。在这篇综述中，我们重点介绍了16种天然来源的生物活性物质对dox相关认知缺陷的神经保护作用，这些生物活性物质包括高阳姜素、核桃苷、芦丁、槲皮素、儿茶素、柚皮苷、虾青素、多元数据素、咖啡酸苯乙酯、小檗碱、c-藻蓝蛋白、omega-3多不饱和脂肪酸、α -硫辛酸、diosmin、百里醌和姜黄素。结果考虑到对学习、记忆障碍和探索行为的重视，我们的文献综述表明，减少氧化应激（OS）、神经炎症和细胞凋亡是核心途径。然而，神经发生、突触可塑性、乙酰胆碱酯酶（AChE）活性水平的改变，以及其他不常见的过程，如自噬、脑线粒体功能障碍、坏死性下垂和氮胁迫等，也有报道。结论除了已发表的研究的价值之外，还迫切需要进一步的研究来评估围绕这一现象的天然化合物，通过额外的模拟临床环境，使用新的配方，并调查所涉及的机制的新见解。

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引用次数: 0

Neuroprotective effects of human adipose-derived stem cells in AD rat model focusing on CD11b and synaptophysin 人脂肪源性干细胞在AD大鼠模型中的神经保护作用，聚焦CD11b和突触素

Brain disorders (Amsterdam, Netherlands)

Pub Date : 2025-09-15 DOI: 10.1016/j.dscb.2025.100285

Maryam Doshmanziari , Arash Sarveazad , Fatemeh Moradi , Sara Simorgh , Marjan Shariatpanahi , Mina Eftekharzadeh

Alzheimer's disease (AD) is the most prevalent type of progressive cognitive impairment and is generally age-related. Stem cell therapy, as a new way of treating neurological disorders can improve the nervous system, but there is not enough perception about the underlying mechanisms. In this investigation, we have studied the effect of human adipose-derived stem cells (hADSCs) intravenous injection on CD11b and Synaptophysin (SYP) expression in the hippocampus of the AD rat. We used thirty-two male rats (four groups): AD model, Control, Sham and hADSCs (AD+Sc) group. Morris Water Maze (MWM) was utilized to evaluate alterations in behavior. Also, double immunofluorescent staining results determined SYP and CD11b expressions. According to the MWM results, the AD+Sc group's spatial memory improved following the injection of hADSCs. A markedly lower number of dead cells was observed in the AD+Sc group in comparison to the AD rat model, as assessed through Nissl staining. Consequently, hADSCs administration considerably reduced the level of CD11b about 6-fold and increased SYP expression level about 8-fold in the AD+Sc group comparing to the AD group. Firstly, we have demonstrated that hADSCs had neuroprotective effects on AD group through increase in SYP and reduction in CD11b expression. Based on reversal expression of CD11b and SYP in AD model before and after treatment with hADSCs, it seems that microglia have a key role in treatment of the cognitive and learning dysfunction via improving of synaptic function in AD.

阿尔茨海默病（AD）是最常见的进行性认知障碍类型，通常与年龄有关。干细胞治疗作为一种治疗神经系统疾病的新方法，可以改善神经系统，但其机制尚不清楚。在这项研究中，我们研究了静脉注射人脂肪源性干细胞（hADSCs）对AD大鼠海马中CD11b和Synaptophysin （SYP）表达的影响。选用雄性大鼠32只，分为4组：AD模型组、对照组、假手术组和hascs （AD+Sc）组。Morris水迷宫（Morris Water Maze， MWM）用于评估行为的改变。双免疫荧光染色检测SYP和CD11b的表达。根据MWM结果，注射hADSCs后，AD+Sc组的空间记忆得到改善。通过尼氏染色，与AD大鼠模型相比，AD+Sc组的死细胞数量明显减少。因此，与AD组相比，hADSCs使AD+Sc组的CD11b水平降低了约6倍，SYP表达水平增加了约8倍。首先，我们通过增加SYP和降低CD11b表达，证明了hscs对AD组具有神经保护作用。基于hADSCs治疗前后AD模型中CD11b和SYP的逆转表达，提示小胶质细胞通过改善AD的突触功能在治疗认知和学习功能障碍中发挥关键作用。

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引用次数: 0

The prevalence of hyperglycemia in patients on admission with acute stroke without prior history of diabetes mellitus and its impact on the outcome in Pakistan 巴基斯坦无糖尿病史的急性脑卒中患者入院时高血糖的患病率及其对预后的影响

Brain disorders (Amsterdam, Netherlands)

Pub Date : 2025-09-11 DOI: 10.1016/j.dscb.2025.100283

Kainat Amjad, Malala Khan, Husnain Hashim, Saima Shafait, Saeed Arif

Background

Acute stroke is a leading cause of disability and death worldwide, and hyperglycemia is frequently present at admission, often complicating patient outcomes (Williams, et al.). While the relationship between stroke and hyperglycemia has been widely studied in individuals with diabetes, limited evidence exists regarding its role in patients without a prior diagnosis of diabetes (Lau, et al.).

Objective

This study aimed to determine the prevalence of hyperglycemia in acute stroke patients without known diabetes and to evaluate its effect on short- and long-term outcomes in Pakistan.

Method

A retrospective review was conducted of acute stroke patients without pre-existing diabetes. Blood glucose levels at admission, hospital stay duration, and outcomes in terms of neurological recovery, functional independence, and mortality were analyzed.

Results

Of 378 patients, 25.4 % had pre-existing diabetes. Admission blood glucose testing showed that 35.2 % were hyperglycemic. A significant association was observed between glucose levels and prior diabetes status. Among hyperglycemic patients, 73 % had stress hyperglycemia, while 27 % had chronic hyperglycemia. Patients with hyperglycemia experienced longer hospital stays and higher disability scores, as measured by the Modified Rankin Scale (MRS), suggesting poorer recovery. Overall, 15.6 % of patients died during hospitalization, with admission hyperglycemia strongly associated with increased mortality.

Conclusion

Hyperglycemia at admission is common in stroke patients without diabetes and is linked to worse clinical outcomes, including prolonged hospitalization, greater disability, and higher mortality (Stead, et al.) [3]. These findings highlight the need for further studies to define the role of hyperglycemia in acute stroke management in both diabetic and non-diabetic populations.

背景：急性中风是世界范围内致残和死亡的主要原因，入院时高血糖经常出现，常常使患者的预后复杂化（Williams等）。虽然卒中和高血糖之间的关系已在糖尿病患者中得到广泛研究，但关于其在未确诊糖尿病患者中的作用的证据有限（Lau, et al.）。目的：本研究旨在确定巴基斯坦无已知糖尿病的急性卒中患者高血糖的患病率，并评估其对短期和长期预后的影响。方法回顾性分析无糖尿病的急性脑卒中患者。分析入院时的血糖水平、住院时间、神经恢复、功能独立性和死亡率方面的结果。结果378例患者中，25.4%患有糖尿病。入院血糖检查显示35.2%为高血糖。在血糖水平和既往糖尿病状态之间观察到显著的关联。在高血糖患者中，73%为应激性高血糖，27%为慢性高血糖。根据修正兰金量表（MRS）的测量，高血糖患者住院时间更长，残疾评分更高，表明恢复较差。总体而言，15.6%的患者在住院期间死亡，入院时高血糖与死亡率增加密切相关。结论：入院时高血糖在无糖尿病的脑卒中患者中很常见，并与较差的临床结果相关，包括延长住院时间、更大的残疾和更高的死亡率（Stead, et al.）。这些发现强调需要进一步的研究来确定高血糖在糖尿病和非糖尿病人群急性卒中管理中的作用。

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引用次数: 0

Case report of individualized dose modifying practice with pulsed oral dexamethasone for mild chronic inflammatory demyelinating polyneuropathy: Could a lower dose suffice? 脉冲口服地塞米松治疗轻度慢性炎症性脱髓鞘性多神经病变个体化剂量调整的病例报告：低剂量是否足够？

Brain disorders (Amsterdam, Netherlands)

Pub Date : 2025-09-06 DOI: 10.1016/j.dscb.2025.100281

Kit Mun Loke , Fu Liong Hiew

Pulsed corticosteroid is highly effective in the treatment of Chronic Inflammatory Demyelinating Polyneuropathy (CIDP), with the advantage of a higher potential in achieving therapy-free remission in comparison to immunoglobulin. More recently, fixed pulsed corticosteroid regime have been demonstrated to have better efficacy with fewer side effects than daily dosing. However, distinct gaps exist in current treatment guidelines on what is the best corticosteroid regimen. We illustrate a novel treatment perspective with an individualised pulsed oral dexamethasone dosing modifying method in 2 treatment-naïve patients with typical CIDP based on clinical response and side effect profiles. Both patients achieved remission on assessment with clinically validated CIDP disability and impairment scales. Dose reduction as early as the third month did not lead to clinical deterioration. The similarities between both patients were young females with no co-morbidities, early disease presentation, mild sensorimotor impairment, and functional disability at presentation and less aggressive disease progression. Therefore, in a selected group of CIDP patients, a lower cumulated corticosteroid dose may be sufficient to achieve clinical remission with individualized dosing modification. To the best of our knowledge, this innovative corticosteroid treatment insight for CIDP has not been described in the literature.

脉冲皮质类固醇在治疗慢性炎症性脱髓鞘多神经病变（CIDP）方面非常有效，与免疫球蛋白相比，具有更高的实现无治疗缓解的潜力。最近，固定脉冲皮质类固醇疗法已被证明比每日给药具有更好的疗效和更少的副作用。然而，在目前的治疗指南中，关于什么是最好的皮质类固醇治疗方案存在明显的差距。我们在2例treatment-naïve典型CIDP患者的临床反应和副作用的基础上，阐述了一种新的治疗视角，即个体化脉冲口服地塞米松剂量调整方法。两名患者在临床验证的CIDP残疾和损害量表评估中均获得缓解。早在第3个月就减少剂量并没有导致临床恶化。这两例患者的相似之处是年轻女性，无合并症，早期发病，轻度感觉运动障碍，首发时功能残疾，疾病进展较小。因此，在一组选定的CIDP患者中，较低的皮质类固醇累积剂量可能足以通过个体化剂量调整实现临床缓解。据我们所知，这种创新的皮质类固醇治疗CIDP的见解尚未在文献中描述。

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引用次数: 0

Psychosis preceding motor symptoms in Huntington’s disease: A psychiatric inpatient case series 亨廷顿舞蹈病运动症状前的精神病：精神科住院病人病例系列

Brain disorders (Amsterdam, Netherlands)

Pub Date : 2025-09-06 DOI: 10.1016/j.dscb.2025.100279

Beatriz Fonseca Silva, Pedro Felgueiras, Tatiana Pessoa, Bárbara Moura, André Oliveira

Introduction

Huntington’s Disease (HD) is a neurodegenerative condition associated with neuronal loss and atrophy in the caudate nucleus and putamen. The most prevalent disease manifestations include movement symptoms like chorea, a progressive cognitive decline and neuropsychiatric signs. Psychosis presenting before other symptoms is rare in HD and is often a confounding fator in differential diagnosis, evoking other psychiatric syndromes. We aim to report on three cases of HD that presented with psychotic symptomatology.

Case description

The three patients discussed displayed psychotic symptoms several years before the motor manifestations of the disease. In this context, they were all admitted in a psychiatric ward, despite the presence of family history, the clinical course and previous evaluations by Neurology.

Discussion

Possible mechanisms that explain the prevalence of psychotic symptoms in HD and their eventual emergence in earlier disease phases have been identified. Neglecting this fact might delay diagnosis and possible interventions in patients and their families (including, possibly, genetic testing). Although it is a rare clinical presentation of HD, signs like heavy family history of similar disease evolution should lead to a rigorous diagnostic workup.

Conclusion

Regarding these clinical cases, we highlight the importance of considering HD in patients with psychotic symptoms and suspicion of a hereditable disease. In fact, earlier differential diagnosis would allow better management of symptomatology. In these cases, treatment had to be readjusted considering the neurological implications, to improve the quality of life.

亨廷顿氏病（HD）是一种神经退行性疾病，与尾状核和壳核的神经元丢失和萎缩有关。最常见的疾病表现包括舞蹈病等运动症状，进行性认知能力下降和神经精神症状。精神病在其他症状之前出现在HD中是罕见的，并且经常是鉴别诊断的混淆因素，引起其他精神症状。我们的目的是报告三例HD表现为精神病症状。病例描述：本文讨论的3例患者在出现运动症状前几年就表现出精神症状。在这种情况下，尽管存在家族史、临床病程和神经病学先前的评估，但他们都住进了精神科病房。已经确定了解释HD中精神病症状的流行及其在疾病早期阶段最终出现的可能机制。忽视这一事实可能会延误对患者及其家属的诊断和可能的干预（可能包括基因检测）。虽然这是一种罕见的HD临床表现，但类似疾病演变的严重家族史等迹象应该导致严格的诊断检查。结论对于这些临床病例，我们强调在有精神病症状和怀疑遗传病的患者中考虑HD的重要性。事实上，早期鉴别诊断可以更好地控制症状。在这些病例中，治疗必须重新调整考虑到神经系统的影响，以提高生活质量。

{"title":"Psychosis preceding motor symptoms in Huntington’s disease: A psychiatric inpatient case series","authors":"Beatriz Fonseca Silva, Pedro Felgueiras, Tatiana Pessoa, Bárbara Moura, André Oliveira","doi":"10.1016/j.dscb.2025.100279","DOIUrl":"10.1016/j.dscb.2025.100279","url":null,"abstract":"<div><h3>Introduction</h3><div>Huntington’s Disease (HD) is a neurodegenerative condition associated with neuronal loss and atrophy in the caudate nucleus and putamen. The most prevalent disease manifestations include movement symptoms like chorea, a progressive cognitive decline and neuropsychiatric signs. Psychosis presenting before other symptoms is rare in HD and is often a confounding fator in differential diagnosis, evoking other psychiatric syndromes. We aim to report on three cases of HD that presented with psychotic symptomatology.</div></div><div><h3>Case description</h3><div>The three patients discussed displayed psychotic symptoms several years before the motor manifestations of the disease. In this context, they were all admitted in a psychiatric ward, despite the presence of family history, the clinical course and previous evaluations by Neurology.</div></div><div><h3>Discussion</h3><div>Possible mechanisms that explain the prevalence of psychotic symptoms in HD and their eventual emergence in earlier disease phases have been identified. Neglecting this fact might delay diagnosis and possible interventions in patients and their families (including, possibly, genetic testing). Although it is a rare clinical presentation of HD, signs like heavy family history of similar disease evolution should lead to a rigorous diagnostic workup.</div></div><div><h3>Conclusion</h3><div>Regarding these clinical cases, we highlight the importance of considering HD in patients with psychotic symptoms and suspicion of a hereditable disease. In fact, earlier differential diagnosis would allow better management of symptomatology. In these cases, treatment had to be readjusted considering the neurological implications, to improve the quality of life.</div></div>","PeriodicalId":72447,"journal":{"name":"Brain disorders (Amsterdam, Netherlands)","volume":"20 ","pages":"Article 100279"},"PeriodicalIF":0.0,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145050592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A case series of infantile epileptic spasms syndrome: diagnosis, treatment choices and genetic landscape 婴儿癫痫性痉挛综合征病例系列：诊断、治疗选择和遗传景观

Brain disorders (Amsterdam, Netherlands)

Pub Date : 2025-09-05 DOI: 10.1016/j.dscb.2025.100280

C. Tsimakidi, M. Gontika, St. Giamouri, N. Kallias, C. Kotsalis, F. Mylona, D. Gkougka

Objective

We present a one‑year case series of nine patients diagnosed with Infantile Epileptic Spasms Syndrome (IESS) treated in our clinic.

Methods

Nine (9) patients presenting with spasms underwent electroencephalogram (EEG) which confirmed the diagnosis of IESS in all cases. Their clinical presentation, EEG, MRI and genetic findings are reviewed.

Results

Hypsarrhythmia and spasms resolved in all patients. However developmental outcomes as psychomotor delay (4/9) and autism (3/9) and the progression to other types of epilepsy (6/9) remain under evaluation. Genetic and imaging findings are provided.

Conclusion

IESS encompasses a spectrum of underlying aetiologies and continues to pose therapeutic challenges. While aggressive treatment is necessary in the acute phase, long-term psychomotor outcomes depend on aetiology and remain largely unpredictable. Genetic testing plays a key role in clarifying underlying causes and informing prognosis.

目的介绍在我院治疗的9例婴幼儿癫痫痉挛综合征（IESS）患者的一年来的病例系列。方法9例痉挛患者均行脑电图（EEG）检查，均确诊为IESS。现就其临床表现、脑电图、核磁共振及基因表现作一综述。结果所有患者心律失常及痉挛症状均得到缓解。然而，发展结果如精神运动迟缓（4/9）和自闭症（3/9）以及进展为其他类型癫痫（6/9）仍在评估中。提供遗传和影像学检查结果。结论：ess包含一系列潜在的病因，并继续对治疗提出挑战。虽然在急性期积极治疗是必要的，但长期的精神运动结果取决于病因，在很大程度上仍然是不可预测的。基因检测在明确病因和告知预后方面起着关键作用。

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引用次数: 0

The relationship between inflammatory markers in cerebrospinal fluid in healthy controls and in patients with severe essential tremor before and after deep brain stimulation 脑深部电刺激前后健康人与严重特发性震颤患者脑脊液炎症标志物的关系

Brain disorders (Amsterdam, Netherlands)

Pub Date : 2025-09-04 DOI: 10.1016/j.dscb.2025.100277

Peter Zsigmond , Emmanuel Bäckryd , Bijar Ghafouri

Objective

Essential tremor (ET) is the most common movement disorder, with a prevalence of approximately 5 % in individuals over 65 years old. The pathophysiology behind ET is still largely unknown but emerging evidence indicates that ET can be a neurodegenerative disorder. Our aim in this pilot study was to evaluate alterations in inflammatory cytokines in ET patients undergoing deep brain stimulation (DBS) compared to healthy controls.

Methods

Ten patients with severe ET were included in this study. Cerebrospinal fluid was analyzed in healthy controls and in ET patients before and after deep brain stimulation. The samples were analyzed with a U-PLEX assay, based on an electrochemiluminescent detection method.

Results

Several cytokines were downregulated or upregulated in patients with ET compared to the healthy control group. Interestingly, macrophage migration inhibitory factor (MIF) was one of the significantly upregulated inflammatory mediators. There was no difference in the analyzed cytokines before and after DBS.

Conclusion

Inflammatory proteins are altered in patients with ET compared to healthy individuals. The finding of an upregulation of MIF, an interesting cytokine that plays a role in other neurodegenerative disorders, suggests evidence for a neurodegenerative pathophysiology in ET. Inflammatory biomarkers might be promising to be future biomarkers and targets of therapeutics against several neurodegenerative disorders.

特发性震颤（ET）是最常见的运动障碍，在65岁以上的人群中患病率约为5%。ET背后的病理生理机制在很大程度上仍然未知，但新出现的证据表明ET可能是一种神经退行性疾病。我们在这项初步研究中的目的是评估接受深部脑刺激（DBS）的ET患者与健康对照组相比炎症细胞因子的变化。方法选取10例重度ET患者。分析了健康对照组和ET患者在深部脑刺激前后的脑脊液。采用基于电化学发光检测方法的U-PLEX法对样品进行分析。结果与健康对照组相比，ET患者的几种细胞因子下调或上调。有趣的是，巨噬细胞迁移抑制因子（MIF）是显著上调的炎症介质之一。DBS前后分析的细胞因子无差异。结论与健康人相比，ET患者的炎症蛋白发生了改变。MIF是一种在其他神经退行性疾病中发挥作用的有趣细胞因子，其上调的发现为ET的神经退行性病理生理提供了证据。炎症生物标志物可能有望成为未来几种神经退行性疾病治疗的生物标志物和靶点。

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引用次数: 0

Erratum regarding missing Editor Disclosure statements in previously published articles 关于先前发表的文章中缺少编辑披露声明的勘误

Brain disorders (Amsterdam, Netherlands)

Pub Date : 2025-09-01 DOI: 10.1016/j.dscb.2025.100272

引用次数: 0

Oral condition mediates the relationship between dementia risk and fractional anisotropy 口腔状况介导痴呆风险与分数各向异性之间的关系

Brain disorders (Amsterdam, Netherlands)

Pub Date : 2025-09-01 DOI: 10.1016/j.dscb.2025.100276

Keisuke Kokubun , Kiyotaka Nemoto , Yoshinori Yamakawa

As the aging population advances, interest in the oral condition and dementia of the elderly is increasing day by day. As a result, there is a tendency for research showing that deterioration of oral condition is related to dementia and brain structure. However, it remains unclear what kind of changes in brain structure are brought about by deterioration of oral condition. In this study, we analyzed the relationship between dementia risk, oral condition, and brain structure using data from 137 healthy men and women collected in Japan. As a result, it was shown that oral condition is significantly correlated with dementia risk and fractional anisotropy, including the anterior limb of internal capsule, and may mediate between the two.

随着人口老龄化的推进，人们对老年人口腔疾病和痴呆的关注日益增加。因此，有研究表明，口腔状况的恶化与痴呆症和大脑结构有关。然而，目前尚不清楚口腔状况的恶化会带来什么样的大脑结构变化。在这项研究中，我们利用从日本收集的137名健康男性和女性的数据，分析了痴呆症风险、口腔状况和大脑结构之间的关系。结果表明，口腔状况与痴呆风险和分数各向异性（包括内囊前肢）显著相关，并可能在两者之间起中介作用。

引用次数: 0

Assessing adverse reactions in people living with epilepsy on levetiracetam 评估癫痫患者服用左乙拉西坦的不良反应

Brain disorders (Amsterdam, Netherlands)

Pub Date : 2025-09-01 DOI: 10.1016/j.dscb.2025.100273

Luqman Ogunjimi , Bamidele Osalusi , Akinyinka Alabi , Abdullahi Murtala , Emmanuel Irokosu , Aderonke Aderinola , Uka Aaron , Damilola Ogungbemi , Bolanle Falujo , Latifat Elegbede , Asisat Adegoke , Fedora Ojini , Ayomide Oladipupo , Ibironke Oyenuga , Doyinsola Omilana , Oluwatobiloba Oluseyije , Fehintola Fatai

Background

This study aimed to evaluate factors associated with adverse drug reaction (ADR) among people with epilepsy (PWE) on Levetiracetam (LEV) monotherapy.

Method

This descriptive, cross-sectional study, utilized a total purposive sampling method, to recruit 102 consenting participants on LEV monotherapy. Seizure classification was determined using the 2017 International League against Epilepsy (ILAE) guideline. Liverpool Adverse Events Profile (LAEP) was employed to evaluate ADR in individuals on LEV monotherapy.

Result

There were 44 (43 %) had ADR [single 21(20.59 %) vs multiple 23(22.55 %)], while 58 (56.86 %) had No Adverse Drug Reaction (NADR) respectively. The most common ADRs were headaches 20 (19.6 %), disturbed sleep (18.6 %), and dizziness 16 (15.7 %). Demographic and clinical characteristics were comparable among ADR, and NADR, except for marital status (p0.043), lower age at onset [23.89 ± 13.30 vs 32.32 ± 20.34 (p0.027)], and higher LAEP score [24.48 ± 5.55 vs 19.00 ± 0.00 (p < 0.001)]. The parameters were also comparable in single and multiple reactions except for marital status (p0.035), and etiology (p0.012). Furthermore, lower age at onset (p0.027), and higher LAEP score (p < 0.001) were identified factors associated with ADR among participants. However, none of these predicted ADR.

Conclusion

Nearly half of the participants had ADR, with neurological ADRs being the commonest, and 23 % of them had multiple ADRs. Furthermore, lower age at onset and higher LAEP scores were significantly associated with ADR. Healthcare providers should focus on identifying and mitigating these ADRs to improve the quality of care in PWE.

本研究旨在评价癫痫（PWE）患者左乙拉西坦（LEV）单药治疗药物不良反应（ADR）的相关因素。方法本研究采用全目的抽样方法，招募102名同意接受LEV单药治疗的受试者。根据2017年国际抗癫痫联盟（ILAE）指南确定癫痫发作分类。采用利物浦不良事件档案（LAEP）评估LEV单药治疗个体的不良反应。结果44例（43%）发生不良反应（单例21例（20.59%）vs多例23例（22.55%）），58例（56.86%）无不良反应（NADR）。最常见的不良反应是头痛20%（19.6%）、睡眠不安（18.6%）和头晕16%（15.7%）。除婚姻状况（p0.043）、发病年龄较低[23.89±13.30 vs 32.32±20.34 (p0.027)]、LAEP评分较高[24.48±5.55 vs 19.00±0.00 (p < 0.001)]外，ADR与NADR的人口统计学和临床特征具有可比性。除婚姻状况（p0.035）和病因（p0.012）外，单次和多次反应的参数也具有可比性。此外，较低的发病年龄（p0.027）和较高的LAEP评分（p < 0.001）被确定为与参与者的不良反应相关的因素。然而，这些都不能预测不良反应。结论近一半的受试者出现不良反应，其中以神经系统不良反应最为常见，23%的受试者出现多重不良反应。此外，较低的发病年龄和较高的LAEP评分与不良反应显著相关。医疗保健提供者应专注于识别和减轻这些不良反应，以提高PWE的护理质量。

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引用次数: 0