Utjecaj antiepileptičke terapije na promjene u elektroencefalografskom zapisu

master's thesis

• Title (english): Influence of antiepileptic therapy on changes in electroencephalographic record
• Author: Ana Vuksanović
• Mentor: Željka Petelin Gadže (mentor)
• Committee member: Zdravka Poljaković-Skurić (predsjednik povjerenstva)
• Committee member: Mario Habek (član povjerenstva)
• Committee member: Željka Petelin Gadže (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Neurology); Zagreb
• Defense date and country: 2021-09-25, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Neurology

Abstract

Antiepileptički lijekovi su lijekovi korišteni u terapiji epilepsije, bolesti koja se očituje abnormalnim neuronskim okidanjima koja rezultiraju pojavom napadaja koji se, ovisno o patofiziološkom mehanizmu nastanka, mogu manifestirati u fokalnom i
generaliziranom obliku. Dugogodišnja istraživanja o promjenama moždanih ritmova, pri terapiji AEL, pokazuju da postoji dosljednost u dobivenim rezultatima pojedinih lijekova, ali isto tako i velika varijabilnost ovisna o individualnim osobitostima pacijenta. U obzir treba uzeti da na EEG osim lijeka koji se primjenjuje utječu i dob, spol, emocionalni status, budnost, krvni tlak, kava, pušenje, metabolički status, komorbiditeti, istodobna primjena drugih lijekova i dr. Upravo to može objasniti nedosljednost utjecaja na EEG pojedinih lijekova (npr. valproat). Osnovni zaključak utjecaja AEL je da utječu na suzbijanje neuronskih pražnjenja ovisno o njihovoj koncentraciji u plazmi, dovode do povećanja beta aktivnosti (klonazepam, karbamazepin) te usporavanja pozadinske aktivnosti (karbamazepin, fenitoin, gabapentin). EEG još uvijek nije moguće koristiti u praćenju terapije AEL ni za individualno kreiranje terapije zbog nedovoljne istraženosti djelovanja AEL na EEGzapis te velike varijabilnosti dobivenih rezultata. Za razliku od njega, qEEG koji u obzir uzima koncentracije lijekova, smatra se preciznijim te se smatra potencijalnom metodom korištenom za razvoj strategije liječenja epileptičkih napadaja.

Abstract (english)

Antiepileptic drugs are drugs used in treatment of epilepsy, a disease manifested by abnormal neuronal triggers that result in seizures which, depending on the pathophysiological mechanism of occurrence, can manifest in focal and generalized
form. Long-term research on brain rhythm changes in the treatment of AED shows that there is consistency in the results of individual drugs, but also a large variability depending on the individual characteristics of the patient. It should be taken into
account that in addition to the used drug, the EEG is also affected by age, gender, emotional status, alertness, blood pressure, coffee, smoking, metabolic status, comorbidities, concomitant use of other drugs, etc. This may explain the inconsistent effect on the EEG of individual drugs (e.g. valproate). The main conclusion on the influence of AEDs is that they affect the suppression of neuronal discharges depending on their concentration in plasma. Furthermore, they lead to an increase of beta activity (clonazepam, carbamazepine) and deceleration of background activity (carbamazepine, phenytoin, gabapentin). It is still not possible to use EEG in the monitoring of AED therapy or in creating individual therapy due to insufficient research of the effect of AED on the EEG record and the large variability of the obtained results. In contrast, qEEG, which takes drug concentrations into account, is considered more accurate and is a potential method used to develop a strategy for
treating epileptic seizures.

• Keywords: epilepsija; antiepileptički lijekovi; elektroencefalografija; farmako-EEG; moždani ritmovi
• Keywords (english): epilepsy; antiepileptic drugs; electroencephalography; pharmaco-EEG; brain rhythms
• Language: croatian
• URN:NBN: urn:nbn:hr:105:499080
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2022-05-20 09:01:56