COMPARATIVE COGNITIVE EFFECTS OF PHENOBARBITAL, PHENYTOIN, AND VALPROATE IN HEALTHY-ADULTS
COMPARATIVE COGNITIVE EFFECTS OF PHENOBARBITAL, PHENYTOIN, AND VALPROATE IN HEALTHY-ADULTS
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DOI：
10.1212/wnl.45.8.1494
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发表时间：
1995-08-01
期刊：
影响因子：
9.9
通讯作者：
KING, DW
中科院分区：
文献类型：
--
作者：
MEADOR, KJ;LORING, DW;KING, DW
抗癫痫药物（AEDs）对认知的相对影响存在争议。我们采用随机、双盲、不完全区、交叉设计比较了59名健康成人苯巴比妥、苯妥英和丙戊酸的认知效果。认知评估在基线时进行，在每种药物治疗1个月后（每个受试者2个AED），在两次重复基线时进行，每次AED治疗11周后进行。神经心理测试包括12个测试，共22个变量：选择反应时间、P3事件相关电位、手指敲击、拉斐特槽钉板、选择性提醒测试、段落记忆、复杂图形、符号数字模态测试、Stroop测试、视觉序列加法测试；霍普金斯症状检查表和情绪状态概况。与非药物基线相比，超过一半的变量显示出AED效应，并且所有三种AED都产生了一些不良影响。大约三分之一的变量存在不同的AED对认知的影响。苯巴比妥的表现最差；苯妥英与丙戊酸钠在临床上无显著差异。
The relative effects of antiepileptic drugs (AEDs) on cognition are controversial. We compared the cognitive effects of phenobarbital, phenytoin, and valproate in 59 healthy adults using a randomized, double-blind, incomplete-block, crossover design. Cognitive assessments were conducted at baseline, after 1 month on each drug (two AEDs per subject), and at two repeat baselines 11 weeks alter each AED treatment. The neuropsychological battery included 12 tests, yielding 22 variables: Choice Reaction Time, P3 Event-Related Potential, Finger Tapping, Lafayette Grooved Pegboard, Selective Reminding Test, Paragraph Memory, Complex Figures, Symbol Digit Modalities Test, Stroop Test, Visual Serial Addition Test; Hopkins Symptom Checklist, and Profile of Mood States. More than one-half of the variables exhibited AED effects when compared with nondrug baselines, and all three AEDs produced some untoward effects. Differential AED effects on cognition were present for approximately one-third of the variables. Phenobarbital produced the worst performance; there was no clinically significant difference between phenytoin and valproate.