报告抗癫痫药物引起中枢神经系统相关副作用的患者血浆总tau浓度较高。

IF 2.7 3区医学 Q2 CLINICAL NEUROLOGY

Seizure-European Journal of Epilepsy Pub Date : 2025-02-01 DOI:10.1016/j.seizure.2025.01.015

Klara Andersson , Sarah Akel , Fredrik Asztély , David Larsson , Henrik Zetterberg , Johan Zelano

{"title":"报告抗癫痫药物引起中枢神经系统相关副作用的患者血浆总tau浓度较高。","authors":"Klara Andersson , Sarah Akel , Fredrik Asztély , David Larsson , Henrik Zetterberg , Johan Zelano","doi":"10.1016/j.seizure.2025.01.015","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Side effects from antiseizure medication (ASM) are common in epilepsy but biomarkers for detection and monitoring are missing. This study investigated associations between CNS-related side effects from ASM and blood concentrations of the brain injury markers neurofilament-light (NFL), total tau, glial acidic fibrillary protein (GFAP), S100 calcium-binding protein B (S100B) and neuron-specific enolase (NSE).</div></div><div><h3>Methods</h3><div>This is a population-based cohort study of adults with epilepsy recruited from five Swedish outpatient neurology clinics from December 2020 to April 2023. Side effects classified as CNS-related: tiredness, dizziness, headache, concentration, memory, mood, motor/tremor, or sleep. Marker concentrations in the groups CNS side effects/no side effects were analyzed with Mann-Whitney U-test and significant differences were included in multivariable logistic regression models adjusting for age, epilepsy duration, seizure status, acquired structural lesion, and mono-/polytherapy.</div></div><div><h3>Results</h3><div>The cohort consisted of 367 patients, 187 (51 %) were females, the median age was 43 years (IQR 30–61), and 123 (34 %) reported CNS side effects. Total tau was higher among participants reporting CNS side effects (median 4.44 (95 %CI 4.12–4.88) pg/ml) compared with participants without side effects (3.84 (95 %CI 3.52–4.07) pg/ml, <em>p</em> < 0.01). The difference remained significant in multivariable regression models. NSE was higher among participants without side effects but did not remain significant in the multivariable regression model. No differences were observed for NFL, GFAP or S100B.</div></div><div><h3>Conclusions</h3><div>Higher total tau plasma concentration could be associated with increased risk of CNS side effects from ASM. Longitudinal studies could determine if this reflects vulnerability or detrimental effects of ASM. Trial registration: PREDICT, clinicaltrials.gov identifier NCT04559919.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"125 ","pages":"Pages 99-105"},"PeriodicalIF":2.7000,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Higher plasma total tau concentrations among patients reporting CNS-related side effects from antiseizure medication\",\"authors\":\"Klara Andersson , Sarah Akel , Fredrik Asztély , David Larsson , Henrik Zetterberg , Johan Zelano\",\"doi\":\"10.1016/j.seizure.2025.01.015\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>Side effects from antiseizure medication (ASM) are common in epilepsy but biomarkers for detection and monitoring are missing. This study investigated associations between CNS-related side effects from ASM and blood concentrations of the brain injury markers neurofilament-light (NFL), total tau, glial acidic fibrillary protein (GFAP), S100 calcium-binding protein B (S100B) and neuron-specific enolase (NSE).</div></div><div><h3>Methods</h3><div>This is a population-based cohort study of adults with epilepsy recruited from five Swedish outpatient neurology clinics from December 2020 to April 2023. Side effects classified as CNS-related: tiredness, dizziness, headache, concentration, memory, mood, motor/tremor, or sleep. Marker concentrations in the groups CNS side effects/no side effects were analyzed with Mann-Whitney U-test and significant differences were included in multivariable logistic regression models adjusting for age, epilepsy duration, seizure status, acquired structural lesion, and mono-/polytherapy.</div></div><div><h3>Results</h3><div>The cohort consisted of 367 patients, 187 (51 %) were females, the median age was 43 years (IQR 30–61), and 123 (34 %) reported CNS side effects. Total tau was higher among participants reporting CNS side effects (median 4.44 (95 %CI 4.12–4.88) pg/ml) compared with participants without side effects (3.84 (95 %CI 3.52–4.07) pg/ml, <em>p</em> < 0.01). The difference remained significant in multivariable regression models. NSE was higher among participants without side effects but did not remain significant in the multivariable regression model. No differences were observed for NFL, GFAP or S100B.</div></div><div><h3>Conclusions</h3><div>Higher total tau plasma concentration could be associated with increased risk of CNS side effects from ASM. Longitudinal studies could determine if this reflects vulnerability or detrimental effects of ASM. Trial registration: PREDICT, clinicaltrials.gov identifier NCT04559919.</div></div>\",\"PeriodicalId\":49552,\"journal\":{\"name\":\"Seizure-European Journal of Epilepsy\",\"volume\":\"125 \",\"pages\":\"Pages 99-105\"},\"PeriodicalIF\":2.7000,\"publicationDate\":\"2025-02-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Seizure-European Journal of Epilepsy\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1059131125000214\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Seizure-European Journal of Epilepsy","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1059131125000214","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}

引用次数: 0

摘要

背景：抗癫痫药物（ASM）的副作用在癫痫中很常见，但缺乏检测和监测的生物标志物。本研究探讨了ASM的中枢神经系统相关副作用与脑损伤标志物神经丝光（NFL）、总tau、胶质酸性纤维蛋白（GFAP）、S100钙结合蛋白B （S100B）和神经元特异性烯醇化酶（NSE）血药浓度的关系。方法：这是一项基于人群的队列研究，从2020年12月至2023年4月从瑞典的五个门诊神经病学诊所招募成人癫痫患者。归类为中枢神经系统相关的副作用：疲劳、头晕、头痛、注意力不集中、记忆力、情绪、运动/震颤或睡眠。采用Mann-Whitney u检验分析CNS副作用组/无副作用组的标志物浓度，并在调整年龄、癫痫持续时间、发作状态、获得性结构病变和单一/多种治疗后的多变量logistic回归模型中纳入显著差异。结果：该队列包括367例患者，187例（51%）为女性，中位年龄为43岁（IQR 30-61）， 123例（34%）报告中枢神经系统副作用。报告中枢神经系统副作用的参与者的总tau蛋白（中位数4.44 (95% CI 4.12-4.88) pg/ml）高于无副作用的参与者（中位数3.84 (95% CI 3.52-4.07) pg/ml, p < 0.01）。在多变量回归模型中，差异仍然显著。NSE在没有副作用的参与者中较高，但在多变量回归模型中没有保持显著性。NFL、GFAP和S100B均无差异。结论：较高的tau总血浆浓度可能与ASM引起的中枢神经系统副作用的风险增加有关。纵向研究可以确定这是否反映了ASM的脆弱性或有害影响。试验注册：PREDICT， clinicaltrials.gov识别码NCT04559919。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Higher plasma total tau concentrations among patients reporting CNS-related side effects from antiseizure medication

Background

Side effects from antiseizure medication (ASM) are common in epilepsy but biomarkers for detection and monitoring are missing. This study investigated associations between CNS-related side effects from ASM and blood concentrations of the brain injury markers neurofilament-light (NFL), total tau, glial acidic fibrillary protein (GFAP), S100 calcium-binding protein B (S100B) and neuron-specific enolase (NSE).

Methods

This is a population-based cohort study of adults with epilepsy recruited from five Swedish outpatient neurology clinics from December 2020 to April 2023. Side effects classified as CNS-related: tiredness, dizziness, headache, concentration, memory, mood, motor/tremor, or sleep. Marker concentrations in the groups CNS side effects/no side effects were analyzed with Mann-Whitney U-test and significant differences were included in multivariable logistic regression models adjusting for age, epilepsy duration, seizure status, acquired structural lesion, and mono-/polytherapy.

Results

The cohort consisted of 367 patients, 187 (51 %) were females, the median age was 43 years (IQR 30–61), and 123 (34 %) reported CNS side effects. Total tau was higher among participants reporting CNS side effects (median 4.44 (95 %CI 4.12–4.88) pg/ml) compared with participants without side effects (3.84 (95 %CI 3.52–4.07) pg/ml, p < 0.01). The difference remained significant in multivariable regression models. NSE was higher among participants without side effects but did not remain significant in the multivariable regression model. No differences were observed for NFL, GFAP or S100B.

Conclusions

Higher total tau plasma concentration could be associated with increased risk of CNS side effects from ASM. Longitudinal studies could determine if this reflects vulnerability or detrimental effects of ASM. Trial registration: PREDICT, clinicaltrials.gov identifier NCT04559919.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊

Seizure-European Journal of Epilepsy 医学-临床神经学

CiteScore

5.60

自引率

6.70%

发文量

231

审稿时长

34 days

期刊介绍： Seizure - European Journal of Epilepsy is an international journal owned by Epilepsy Action (the largest member led epilepsy organisation in the UK). It provides a forum for papers on all topics related to epilepsy and seizure disorders.