Study on the efficacy and mechanism of topiramate combined with oxcarbazepine in children with epilepsy
10.3969/j.issn.1004-1648.2025.01.010
- VernacularTitle:托吡酯联合奥卡西平对癫痫患儿的疗效及机制研究
- Author:
Xueyuan LI
1
;
Lingkun HAO
;
Xu FENG
Author Information
1. 075000 张家口市第一医院神经内科
- Publication Type:Journal Article
- Keywords:
epilepsy;
spike clearance rate;
mechanistic target of rapamycin;
nitrogen permease regulator 3-like protein
- From:
Journal of Clinical Neurology
2025;38(1):42-47
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the efficacy and mechanism of topiramate combined with oxcarbazepine in children with epilepsy.Methods The targeted genes of topiramate and oxcarbazepine were analyzed by pharm GKB database;targeted genes of epilepsy in children were screened by GeneCards database;the drug-disease-target gene network map was constructed using Cytoscape 3.9.1 software.A total of 83 children with epilepsy were enrolled and treated for the first time,which were divided into topiramate group and combined drugs group according to the different drugs used.The level of serum mechanistic target of rapamycin(mTOR),epidermal growth factor receptor(EGFR),nitrogen permease regulator 3-like protein(NPRL3)of two groups were observed by ELISA,and the EEG and therapeutic effect were recorded.Results mTOR,EGFR,NPRL3 were the target genes of topiramate combined with oxcarbazepine in the treatment of epilepsy in children.There was no significant difference in seizure rate between the combined drugs group and topiramate group(x2=3.239,P=0.072).The efficacy of combined drug group was significantly better than that of the topiramate group(x2=5.817,P=0.049).The rate of standing wave ratio(SWR)≤2 in EEG spike in the combined drug group was significantly higher than that in the topiramate group(P=0.018).There was different in spike location between combined drug group and topiramate group(P=0.002),while not different statistically in spike region of two groups(P＞0.05).Compared with those in topiramate group,the number of sharp waves in the combination group was significantly reduced at 1 month,3 months and 6 months after treatment,and the sharp wave clearance rate was significantly increased at 1 month,3 months,5 months and 6 months after treatment(P＜0.05-0.01).There was no significant difference in levels of mTOR,EGFR,NPRL3 between the combination group and topiramate groups before treatment(all P＞0.05).Compared with those in topiramate group,the levels of mTOR,EGFR in combined drug group after treatment were significantly decreased(P=0.028,P=0.006),and the level of NPRL3 was significantly increased(P=0.007).Survival analysis showed the median duration of epilepsy work was 6(5,6)months,the seizure rate was 55.42％.Compared with patients with mTOR ≤9.93(16.7％),patients with mTOR＞9.93(93.1％)had a significantly higher probability of epilepsy(x2=11.430,P＜0.001).Conclusion Topiramate combined with oxcarbazepine may reduce the pike and wave rate of EEG,improve epileptic seizures,the mechanism maybe related to the levels of mTOR,NPRL3 and EGFR.
