Natalia Molodozhnikova, Svetlana Prokhorova, Dimitar Monov, Nikolay Lilyanov
{"title":"抗癫痫药物治疗甲状腺功能减退对癫痫患者神经和认知的影响。","authors":"Natalia Molodozhnikova, Svetlana Prokhorova, Dimitar Monov, Nikolay Lilyanov","doi":"10.1002/jnr.70012","DOIUrl":null,"url":null,"abstract":"<div>\n \n <p>The primary objective of this study was to examine neurological disorders and cognitive impairments in patients with secondary hypothyroidism and epilepsy undergoing treatment with antiepileptic medications. The study included 184 patients divided into three groups: Group 1 (subclinical hypothyroidism, <i>n</i> = 60), Group 2 (manifest hypothyroidism, <i>n</i> = 64), and Group 3 (control, <i>n</i> = 60). Patients in Group 2 received levothyroxine therapy (initial dose of 25 μg/day, titrated to 50–100 μg/day), while Groups 1 and 2 were treated with anti-seizure medications (valproic acid, 40 mg/kg/day). Neurological symptoms, including Babinski's reflex abnormalities (<i>χ</i><sup>2</sup> = 8.15, <i>p</i> = 0.017) and sensory disturbances (<i>χ</i><sup>2</sup> = 12.44, <i>p</i> = 0.005), were significantly more frequent in Group 2 than in Group 1. Cognitive test scores were significantly lower in Group 2 compared to Group 3 across all domains (<i>F</i>(2, 181) = 6.55, <i>p</i> = 0.002 for MMSE; <i>F</i>(2, 181) = 4.70, <i>p</i> = 0.010 for FAB; and <i>F</i>(2, 181) = 5.75, <i>p</i> = 0.006 for CDT), with Group 1 showing intermediate results. Regression analysis identified neurodegenerative disease risk (<i>β</i> = 0.34, CI: 0.20–0.48, <i>p</i> < 0.001), anemia (<i>β</i> = 0.32, CI: 0.15–0.49, <i>p</i> = 0.001), and prolonged stress (<i>β</i> = 0.26, CI: 0.12–0.40, <i>p</i> = 0.002) as significant predictors of cognitive decline, while higher education was protective (<i>β</i> = −0.28, CI: −0.42 to −0.14, <i>p</i> = 0.003). An inverse relationship was observed between TSH levels and cognitive scores (<i>r</i> = −0.55, <i>p</i> < 0.001).</p>\n </div>","PeriodicalId":16490,"journal":{"name":"Journal of Neuroscience Research","volume":"103 1","pages":""},"PeriodicalIF":2.9000,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Neurological and Cognitive Effects of Hypothyroidism in Patients With Epilepsy: A Study on Anti-Seizure Medicines Therapy\",\"authors\":\"Natalia Molodozhnikova, Svetlana Prokhorova, Dimitar Monov, Nikolay Lilyanov\",\"doi\":\"10.1002/jnr.70012\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n <p>The primary objective of this study was to examine neurological disorders and cognitive impairments in patients with secondary hypothyroidism and epilepsy undergoing treatment with antiepileptic medications. The study included 184 patients divided into three groups: Group 1 (subclinical hypothyroidism, <i>n</i> = 60), Group 2 (manifest hypothyroidism, <i>n</i> = 64), and Group 3 (control, <i>n</i> = 60). Patients in Group 2 received levothyroxine therapy (initial dose of 25 μg/day, titrated to 50–100 μg/day), while Groups 1 and 2 were treated with anti-seizure medications (valproic acid, 40 mg/kg/day). Neurological symptoms, including Babinski's reflex abnormalities (<i>χ</i><sup>2</sup> = 8.15, <i>p</i> = 0.017) and sensory disturbances (<i>χ</i><sup>2</sup> = 12.44, <i>p</i> = 0.005), were significantly more frequent in Group 2 than in Group 1. Cognitive test scores were significantly lower in Group 2 compared to Group 3 across all domains (<i>F</i>(2, 181) = 6.55, <i>p</i> = 0.002 for MMSE; <i>F</i>(2, 181) = 4.70, <i>p</i> = 0.010 for FAB; and <i>F</i>(2, 181) = 5.75, <i>p</i> = 0.006 for CDT), with Group 1 showing intermediate results. Regression analysis identified neurodegenerative disease risk (<i>β</i> = 0.34, CI: 0.20–0.48, <i>p</i> < 0.001), anemia (<i>β</i> = 0.32, CI: 0.15–0.49, <i>p</i> = 0.001), and prolonged stress (<i>β</i> = 0.26, CI: 0.12–0.40, <i>p</i> = 0.002) as significant predictors of cognitive decline, while higher education was protective (<i>β</i> = −0.28, CI: −0.42 to −0.14, <i>p</i> = 0.003). 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引用次数: 0
摘要
本研究的主要目的是检查继发性甲状腺功能减退和癫痫患者接受抗癫痫药物治疗时的神经系统疾病和认知障碍。184例患者分为3组:1组(亚临床甲状腺功能减退,n = 60), 2组(明显甲状腺功能减退,n = 64), 3组(对照组,n = 60)。2组患者给予左旋甲状腺素治疗(初始剂量25 μg/d,逐渐滴定至50 ~ 100 μg/d), 1、2组患者给予抗癫痫药物(丙戊酸,40 mg/kg/d)。神经系统症状,包括巴宾斯基反射异常(χ2 = 8.15, p = 0.017)和感觉障碍(χ2 = 12.44, p = 0.005), 2组明显高于1组。在所有领域中,第二组的认知测试得分明显低于第三组(F(2,181) = 6.55, p = 0.002);F(2,181) = 4.70, p = 0.010;CDT的F(2,181) = 5.75, p = 0.006),组1为中间结果。回归分析确定了神经退行性疾病的风险(β = 0.34, CI: 0.20-0.48, p
Neurological and Cognitive Effects of Hypothyroidism in Patients With Epilepsy: A Study on Anti-Seizure Medicines Therapy
The primary objective of this study was to examine neurological disorders and cognitive impairments in patients with secondary hypothyroidism and epilepsy undergoing treatment with antiepileptic medications. The study included 184 patients divided into three groups: Group 1 (subclinical hypothyroidism, n = 60), Group 2 (manifest hypothyroidism, n = 64), and Group 3 (control, n = 60). Patients in Group 2 received levothyroxine therapy (initial dose of 25 μg/day, titrated to 50–100 μg/day), while Groups 1 and 2 were treated with anti-seizure medications (valproic acid, 40 mg/kg/day). Neurological symptoms, including Babinski's reflex abnormalities (χ2 = 8.15, p = 0.017) and sensory disturbances (χ2 = 12.44, p = 0.005), were significantly more frequent in Group 2 than in Group 1. Cognitive test scores were significantly lower in Group 2 compared to Group 3 across all domains (F(2, 181) = 6.55, p = 0.002 for MMSE; F(2, 181) = 4.70, p = 0.010 for FAB; and F(2, 181) = 5.75, p = 0.006 for CDT), with Group 1 showing intermediate results. Regression analysis identified neurodegenerative disease risk (β = 0.34, CI: 0.20–0.48, p < 0.001), anemia (β = 0.32, CI: 0.15–0.49, p = 0.001), and prolonged stress (β = 0.26, CI: 0.12–0.40, p = 0.002) as significant predictors of cognitive decline, while higher education was protective (β = −0.28, CI: −0.42 to −0.14, p = 0.003). An inverse relationship was observed between TSH levels and cognitive scores (r = −0.55, p < 0.001).
期刊介绍:
The Journal of Neuroscience Research (JNR) publishes novel research results that will advance our understanding of the development, function and pathophysiology of the nervous system, using molecular, cellular, systems, and translational approaches. JNR covers both basic research and clinical aspects of neurology, neuropathology, psychiatry or psychology.
The journal focuses on uncovering the intricacies of brain structure and function. Research published in JNR covers all species from invertebrates to humans, and the reports inform the readers about the function and organization of the nervous system, with emphasis on how disease modifies the function and organization.