A landmark study from the Institute of Medicine reported that the assessment of cognitive difficulties in children with epilepsy is timely and imperative. Anticonvulsant-induced cognitive impairment could influence the quality of life more than seizure itself in patients. Although the monoaminergic system is involved in the regulation of cognitive process, its role in anticonvulsant-induced cognitive impairment remains unclear. Methods: To explore in vivo monoamine receptor binding activity in patients with anticonvulsant-induced cognitive impairment, each patient underwent PET imaging with both monoamine receptor binding agent ¹¹C-N-methylspiperone and glucose metabolic agent ¹⁸F-FDG. Tests of intelligence quotient (IQ), including verbal IQ (VIQ), performance IQ (PIQ), and full-scale IQ (FSIQ), were performed in each patient. Results: Compared with the patients with monotherapy, patients with polytherapy had significantly lower VIQ, PIQ, and FSIQ (P < 0.01 in each comparison), as well as significantly lower monoamine receptor activities detected in the caudate nucleus, prefrontal cortex, dorsal anterior cingulate cortex, and amygdale (P < 0.05 in each comparison). However, regarding the glucose metabolism, there was no significant difference found in patients with monotherapy or polytherapy (P > 0.05). Conclusion: Monoamine receptor PET imaging could be a promising in vivo imaging biomarker for mapping anticonvulsant-induced cognitive impairment.

医学研究所的一项具有里程碑意义的研究报告说，评估癫痫患儿的认知困难是及时且必不可少的。抗惊厥药引起的认知障碍对患者生活质量的影响远大于癫痫发作本身。尽管单胺能系统参与认知过程的调节，但其在抗惊厥引起的认知障碍中的作用仍不清楚。方法：为探讨抗惊厥性认知障碍患者体内单胺受体结合活性，每位患者均接受了单胺受体结合剂¹¹ C- N-甲基哌咯烷酮和葡萄糖代谢剂^18的PET显像F-FDG。在每位患者中进行了智商（IQ）的测试，包括语言智商（VIQ），表现智商（PIQ）和全面智商（FSIQ）。结果：与单药治疗的患者相比，多药治疗的患者的VIQ，PIQ和FSIQ显着降低（每次比较P <0.01），并且在尾状核，前额叶皮层，背侧前扣带中检测到的单胺受体活性明显降低。皮层和杏仁核（每次比较P <0.05）。但是，就葡萄糖代谢而言，单药治疗或多药治疗的患者之间无显着差异（P > 0.05）。结论： 单胺受体PET成像可能是一种有前途的体内成像生物标志物，用于绘制抗惊厥引起的认知功能障碍。