PHARMACOTHERAPY OF COGNITIVE DEFICIENCY IN EPILEPSY
DOI:
https://doi.org/10.11603/1811-2471.2019.v.i4.10787Keywords:
cognitive and psycho-emotional disorders, epilepsy, anti-epileptic drugs, quality of life, social adaptationAbstract
In recent years, much attention has been paid to the problem of cognitive functioning of patients with various neurological diseases. The problem of increasing cognitive deficits is considered in close connection with the progression of the pathological process, including epilepsy in adults.
The main body. On the basis of a thorough and deep analysis of the literature, the article deals with the problems of cognitive disorders in epilepsy and the possibility of pharmacotherapy aimed at preventing the occurrence of cognitive and psycho-emotional disorders. In adults and the elderly, a long history of epilepsy and other factors can lead to intellectual and mental disorders, up to dementia, severe mental disorders, which are more risky for therapy and psychological correction. These problems may be related to the inadequate and untimely selection of antiepileptic drugs, so the pharmacologically and clinically sound choice of antiepileptic drugs in patients with epilepsy in the presence of cognitive and often affective disorders is a serious task and requires separate consideration.
Conclusion. Epilepsy is characterized by epileptic seizures and cognitive deficits, especially in adults and elderly patients. There is a clear correlation between cognitive impairment and localization of the paroxysmal focus. Preventing the onset of cognitive and cognitive-affective disorders is today the most important task of pharmacotherapy for epilepsy.
References
Burchinskyy, S.G. (2012). Kognitivnyye narusheniya pri epilepsii i problema vybora antikonvulsanta: vozmozhnosti lamotridzhina [Cognitive impairment in epilepsy and the problem of choosing an anticonvulsant: the possibilities of lamotrigine]. Mezhd. nevrol. zhurn. – Int. Neurol. Journal, 1 (47), 113-116 [in Russian].
Voronkova, K.V., Petrukhin, A.S., Pylaeva, O.A., & Kholin, A.A. (2008). Ratsionalnaya antiepilepticheskaya farmakoterapiya [Rational antiepileptic pharmacotherapy]. Moscow: Binom [in Russian].
Kalinin, V.V. (2003). Psikhiatricheskiye problemy epileptologii i neyropsikhiatriya [Psychiatric problems of epileptology and neuropsychiatry]. Sots. i klin. psikhiat. – Soc. and Clin. Psychiatrics, 3, 5-11 [in Russian].
Kalinin, V.V. (2008). Psikhicheskiye rasstroystva pri epilepsii i ikh korrektsiya preparatom lamotridzhin [Mental disorders in epilepsy and their correction with lamotrigine]. Zhurn. nevrol. psikhiat. – Journal of Neurol. Psychiatrist., 108 (2), Epilepsy, 85-90 [in Russian].
Kalinin, V.V. (2006). Psikhicheskiye rasstroystva pri epilepsii. Posobiye dlya vrachey. [Mental disorders in epilepsy. Manual for doctors]. Moscow: OOO “Pechatnyy gorod” [in Russian].
Guseva, E.I., Hecht, A.B., & Kalinin, V.V. (Eds.). (2011). Depressii pri epilepsii [Depression in epilepsy]. [in Russian].
Kalinin, V.V., Zheleznova, E.V., & Zemlyanaya, A.A. (2006). Kognitivnyye narusheniya pri epilepsii [Cognitive impairment in epilepsy]. Zhurn. nevrol. psikhiat. – Journal. of Neurol. Psychiatr., 106 (1), Epilepsy, 64-70 [in Russian].
Karlov, V.A. (2004). Strategiya i taktika terapii epilepsii segodnya [Strategy and tactics of epilepsy therapy today]. Zhurn. nevrol. psikhiat. – Journ. of Neurol. Psychiatrist., 104 (8), 28-34 [in Russian].
Martsenkovskiy, I.A., Martynyuk, V.Yu., & Shvezhkina, V.B. (2009). Vliyaniye protivosudorozhnoy terapii na kognitivnoye funktsionirovaniye bolnykh epilepsiyey [The effect of anticonvulsant therapy on the cognitive functioning of patients with epilepsy]. Zdorovia Ukrainy – Health of Ukraine, 15 (1), 43-45 [in Russian].
Usyukina, M.V., & Frolova, A.V. (2011). Dementsiya pri epilepsii [Dementia in epilepsy]. Zhurn. nevrol. psikhiat. – Journal of Neurol. Psychiatrist., 111 (5/2), Epilepsy, 72-76 [in Russian].
Shomakhova, M.M., Lebedeva, A.V., & Ershov, A.V. (2011). Prediktory narusheniy kognitivnykh funktsiy pri epilepsii [Predictors of cognitive impairment in epilepsy]. Zhurn. nevrol. psikhiat. – Journal of Neurol. Psychiatrist., 111 (5/2), Epilepsy, 65-71 [in Russian].
Bergin, P., Тhomson, P., & Baxendale, S. (2000). Remote memory in epilepsy. Epilepsy, 41, 231-239. DOI: https://doi.org/10.1111/j.1528-1157.2000.tb00145.x
Blake, R.V., Wroe, S.J., & Breen, E.K. (2000). Accelerated forgetting in patients with epilepsy: evidence for impairment in memory consolidation. Brain, 123, 472-483. DOI: https://doi.org/10.1093/brain/123.3.472
Deppe, M., Kellinghaus, C., & Duning, T. (2008). Nerve fiber impairment of anterior thalamocortical circuitry in juvenile myoclonic epilepsy. Neurology, 71, 1981-1985. DOI: https://doi.org/10.1212/01.wnl.0000336969.98241.17
Devisky, O., & D’Esposito, M. (2004). Neurology of cognitive and behavioural disorders. Oxford: Univ. Press.
Hattiangady, B., Rao, M.S., Shetty, G.A., & Shetty, A.K. (2005). Brain–derived neurotrophic factor, phosphorylated cyclic AMP response element binding protein and neuropeptide Y decline as early as middle age in the dentate gyrus and CA1 and CA3 subfields of the hippocampus. Exp. Neurol., 195, 353-371. DOI: https://doi.org/10.1016/j.expneurol.2005.05.014
Rowan, A.J., Ramsay, R.E., & Hauser, W.A. (Eds.). (1997). Epidemiology of seizures and epilepsy in the elderly. Seizures and epilepsy in the elderly. Butterworth–Heinemann; Boston.
Hermann, B.P., Seidenberg, M., & Lee, E.J. (2007). Epigenetic modulation of seizure-induced neurogenesis and cognitive decline. J. Neurosci., 13, 12-20.
Iqbal, N., Caswell, H.L., & Hare, D.J. (2009). Neuropsychological profiles of patients with juvenile myoclonic epilepsy and their siblings: a preliminary controlled experimental video–EEG case series. Epilepsy Behav., 14, 516-521. DOI: https://doi.org/10.1016/j.yebeh.2008.12.025
Khani, Y.A., Andermann, F., & Andermann, E. (2005). Antimyoclonic efficacy of piracetam in idiopathic generalized epilepsy. Epilepsia, 46, 1145-1146. DOI: https://doi.org/10.1111/j.1528-1167.2005.04105.x
Kim, S., Hwang, Y., & Lee, H. (2007). Cognitive impairment in juvenile myoclonic epilepsy. J Clin. Neurol., 3, 86-92. DOI: https://doi.org/10.3988/jcn.2007.3.2.86
Knapp, L.T., & Klann, E. (2005). Potentiation of hippocampal synaptic transmission by superoxide requires the oxidative activation of protein kinase C. Neurosci., 22, 674-683. DOI: https://doi.org/10.1523/JNEUROSCI.22-03-00674.2002
Leppik, I.E., Brodie, M.J., Saetre, E.R., Rowan, A.J., Ramsay, R.E., Macias, F., & Jacobs, M.P. (2006). Outcomes research: clinical trials in the elderly. Epilepsy Res., 68 (1), S71-S76. DOI: https://doi.org/10.1016/j.eplepsyres.2005.07.019
Pascalicchio, T.F., de Araujo Filho, G.M., & da Silva Noffs, M.H. (2007). Neuropsychological profile of patients with juvenile myoclonic epilepsy: a controlled study of 50 patients. Epilepsy Behav., 10, 263-267. DOI: https://doi.org/10.1016/j.yebeh.2006.11.012
Perrine, K., & Kiolbasa, T. (1999) Cognitive deficit in epilepsy and contribution in psychopathology. Neurology, 53 (2), 39-48.
Risse, C.I. (2006). Cognitive outcomes in patients with frontal lobe epilepsy. Epilepsy, 47 (2), 870-879. DOI: https://doi.org/10.1111/j.1528-1167.2006.00699.x
Roebling, R., Scheerer, N., & Uttner, I. (2009). Evaluation of cognition, structural, and functional MRI in juvenile myoclonic epilepsy. Epilepsy, 50, 2456-2465. DOI: https://doi.org/10.1111/j.1528-1167.2009.02127.x
Schmidt, J. (1990). Comparative studies on the anticonvulsant effectiveness of nootropic drugs in kindled rats. Biomed. Biochim. Acta., 49 (5), 413-419.
Shetty, A.K., Hattiangady, B., & Shetty, G.A. (2005). Stem/progenitor cell proliferationfactors FGF–2, IGF–1, and VEGF exhibit early decline during the course of aging in the hippocampus: role of astrocytes. Glia, 51, 173-186. DOI: https://doi.org/10.1002/glia.20187
Shetty, A.K., Hattiangady, B., & Rao, M.S. (2009). Vulnerability of hippocampal GABA–ergic inter–neurons to kainate–induced excitotoxic injury during old age. Cell Mol. Med., 13, 2408-2423. DOI: https://doi.org/10.1111/j.1582-4934.2008.00675.x
Shetty, A.K., Rao, M.S., Hattiangady, B., Zaman, V., & Shetty, G.A. (2004). Hippocampal neurotrophin levels after injury: Relationship to the age of the hippocampus at the time of injury. Neurosci. Res., 78, 520-532. DOI: https://doi.org/10.1002/jnr.20302
Trimble, M., & Schmitz, B. (2002). Seizures, affective disorders and Anticonvulsant Drugs. Clarus Press Ltd, Guildford, UK, 199.
