Objective

Traumatic brain injury is a major health and socioeconomic problem and the first cause of young death worldwide. For this reason, the prevention of post-traumatic brain injury and the research of new methods for it are important today. In this study, we aimed to determine whether the use of antiepileptic drugs contributed to axonal healing after traumatic brain injury.

Methods

Thirty-six Long-Evans rats, each weighing 300–350 g, were used in this study. A total of 6 groups, including the sham, control, and 4 study groups, were determined. A 1.5 mm-sized trauma was created in the biparietal area with a blunt-tipped dissector. Carbamazepine phenytoin valproic acid and levetiracetam (phenytoin: 30 mg/kg, valproic acid: 60 mg/kg, levetiracetam: 80 mg/kg, and carbamazepine: 36 mg/kg) were intraperitoneally administered to the study groups, and the control group intraperitoneally received a physiological saline solution (15 ml/kg) twice daily for 3 days. After 72 h, hemispheres of the sacrificed subjects were taken for examination in biochemistry and histology. Glutathione, malondialdehyde, and NG2 levels in the samples were determined.

Results

No significant difference was found in biochemical measurements. Histopathological examination revealed that the NG2 expression was more intense in the group treated with phenytoin and levetiracetam (phenytoin was partly higher) and the amount of edema decreased. The NG2 expression increased and the edema decreased, though lower in the group treated with carbamazepine and valproic acid, compared with phenytoin and levetiracetam. An increase in the NG2 expression and edema intensity were determined in the control and sham groups.

Conclusion

Antiepileptic drug selection after traumatic brain injury is an important medical matter. Although the patient-oriented selection is essential, the study suggests that the choice of phenytoin, levetiracetam carbamazepine, and valproic acid will, respectively, have an accelerating effect for axonal healing.

中文翻译：

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抗癫痫药物对轴突髓鞘再生的影响：苯妥英钠、左乙拉西坦、卡马西平和丙戊酸，用于创伤性脑损伤后

客观的

创伤性脑损伤是一个重大的健康和社会经济问题，也是全世界年轻人死亡的首要原因。因此，预防创伤后脑损伤及其新方法的研究在当今很重要。在这项研究中，我们旨在确定使用抗癫痫药物是否有助于创伤性脑损伤后的轴突愈合。

方法

本研究使用了 36 只 Long-Evans 大鼠，每只体重 300-350 克。共确定了 6 个组，包括假组、对照组和 4 个研究组。用钝头解剖器在双顶叶区域产生一个 1.5 毫米大小的创伤。研究组腹腔注射卡马西平苯妥英丙戊酸和左乙拉西坦（苯妥英：30 mg/kg，丙戊酸：60 mg/kg，左乙拉西坦：80 mg/kg，卡马西平：36 mg/kg），对照组腹腔注射每天两次接受生理盐水溶液（15 ml / kg），持续3天。72小时后，取处死受试者的半球进行生化和组织学检查。测定样品中的谷胱甘肽、丙二醛和 NG2 水平。

结果

在生化测量中没有发现显着差异。组织病理学检查显示，苯妥英和左乙拉西坦治疗组NG2表达更强烈（苯妥英部分升高），水肿量减少。与苯妥英和左乙拉西坦相比，卡马西平和丙戊酸治疗组的 NG2 表达增加，水肿减少，但较低。在对照组和假手术组中确定了 NG2 表达和水肿强度的增加。

结论

颅脑损伤后抗癫痫药物的选择是一项重要的医学问题。尽管以患者为导向的选择是必不可少的，但研究表明苯妥英钠、左乙拉西坦卡马西平和丙戊酸的选择将分别对轴突愈合产生加速作用。