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Objective:To investigate the efficacy and cognitive function of 3 new antiepileptic drugs Oxcarbazepine (OXC), Lamotrigine (LTG) and Levetiracetam (LEV) in children with self-limited epilepsy with centrotemporal spikes (SeLECTS).Methods:This was a prospective study.A total of 98 children with SeLECTS who were treated in the Second Affiliated Hospital of Xinxiang Medical University from January 2014 to June 2020 were divided into OXC group, LTG group and LEV group according to the applied therapeutic drugs.Video electroencephalograph (EEG), Wechsler Intelligence Scale for Children (WISC) and event-related potentials (ERPs) of the children were collected before treatment and 48 weeks of treatment.Clinical efficacy and impact on cognitive function among the 3 groups were compared.Results:(1)Efficacy: There was no significant difference in the effective rate of seizure reduction after treatment among the 3 groups( χ2=0.808, P=0.668). There was no significant difference in EEG remission rate among the 3 groups( χ2=0.763, P=0.683). (2)Cognitive function: ①Intragroup comparison of WISC findings showed that the full scale score (FIQ) and verbal intelligence quotient (VIQ) were significantly enhanced, and the scores of comprehension, vocabulary, arithmetic, decoding and spelling subtests were more significantly enhanced in OXC group after treatment (all P<0.05). In the LTG group, FIQ, VIQ and operational intelligence quotient (PIQ) were significantly enhanced after treatment (all P<0.05), and the subtest scores of comprehension, vocabulary, arithmetic, mapping and layout were significantly enhanced (all P<0.05). In LEV group, FIQ, VIQ and PIQ were significantly enhanced after treatment (all P<0.05), especially the increase in the VIQ, and the scores of vocabulary, understanding, similarity, arithmetic, decoding and puzzle subtests were significantly enhanced (all P<0.05). Pairwise comparison of WISC findings showed that there were no significant differences in the FIQ, VIQ, PIQ and subtest scores before treatment among the 3 groups (all P>0.05). After treatment, the arithmetic and decoding scores of OXC group were significantly higher than those of LTG group (all P<0.05), which were comparable between OXC group and LEV group (all P>0.05). The PIQ and the scores of mapping and layout in LTG group were significantly higher than those of the other 2 groups (all P<0.05). The LEV group had higher scores in vocabulary, comprehension and spelling than those of the other 2 groups (all P<0.05), which had higher decoding scores than those of the LTG group (all P<0.05). No significant differences were found in decoding scores between LEV and OXC group (all P>0.05). Higher VIQ and FIQ were detected in LEV group than those of the other 2 groups (all P<0.05). ②Intragroup comparison of ERPs showed that the latency of LEV group after treatment was significantly shorter than that before treatment ( P<0.05), and there was no significant difference between the other 2 groups before and after treatment (all P>0.05). Pairwise comparison of ERPs showed that before treatment, there were no significant differences in P300 amplitude and latency among the 3 groups (all P>0.05). After treatment, the latency of LEV group was significantly shorter than that of the other 2 groups ( P<0.05), and there was no significant difference in the amplitude between the 3 groups before and after treatment ( P>0.05). Conclusions:(1)In the treatment of SeLECTS in children, OXC, LTG and LEV have reliable and equivalent effects.(2)OXC, LTG and LEV have protective effects on cognitive function in children with SeLECTS.After treatment, LEV provides the strongest protective effect on FIQ, and the protective effect on VIQ is equivalent to OXC, but better than LTG.LTG is superior in protecting spatial perception and PIQ.
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Objective To explore the effects of repetitive transcranial magnetic stimulation (rTMS) on the improve?ment of depressive behavior and the hippocampus brain derived neurotrophic factor (BDNF) expression in chronic stress-induced depression rats. To further investigate the possible molecular mechanism of rTMS treatment for depres?sion. Methods Forty male Sprague-Dawley rats of SPF grade were randomly divided into the blank control group (n=8) and the stress-induced group (n=30). Singly housing and chronic unpredictable mild stress (CUMS) were used to induce the depression model in stress-induced group. Twenty-four model rats were divided into three groups:model group (with no further treatment), rTMS group (receiving 10 Hz rTMS intervention for 3 weeks) and shame group (receiving pseudo TMS treatments for 3 weeks). Weight measurement, sucrose consumption test and open-field test were used to assess the behavior changes. The rat hippocampal CA3 area of BDNF positive staining cell number and expression levels of BDNF mRNA in hippocampus were examined after intervention. Results The weight reduction rate, score of sucrose consump?tion test and the score of open field test were significantly higher in rTMS group than in model group (P<0.05). The num? ber of BDNF staining positive cells in the hippocampal CA3 area was lower in model group and shame group than in the blank control group whereas was higher in the rTMS group than in the model group (P<0.01). Compared with the model group, the BDNF mRNA relative expression was significantly increased in the hippocampus of rTMS group (P<0.01). Conclusion rTMS can improve depressive behaviors of CUMS rats probably through the increase in expression of BDNF in the hippocampal neurons and neuronal regeneration.