Reassurance on neurodevelopmental risks from antiseizure medications
Cognitive outcomes in children at 2 years of age do not appear to be impacted by exposure to anti seizure medications (ASMs) during pregnancy.
A multicentre US study, published in JAMA Neurology, compared 292 children of women with epilepsy taking ASMs such as lamotrigine and/or levetiracetam, and 90 children of healthy women.
No significant differences were observed between the groups for the primary outcome of language domain and other domains of the Bayley Scales of Infant and Toddler Development (BSD-III).
“This encouraging finding may be due to the use of newer ASMs with lower risk of affecting the immature brain,” the study said.
Instead, language at 2 years of age was associated with known factors associated with child cognitive outcomes such as higher maternal IQ, maternal educational level, and birth weight.
An accompanying editorial said conclusive data on neurodevelopment after ASM exposure was accumulating too slowly.
Promise of pharmacological protection from CTE
Neurokinin-1 (NK1) antagonists may attenuate the potential development of chronic traumatic encephalopathy (CTE) following concussive and blast-induced traumatic brain injury (TBI).
An international study led by the University of South Australia has suggested post-injury administration of NK1 antagonists can block release of the neurotransmitter substance P and consequent tau hyperphosphorylation.
“Alteration in tau phosphorylation is an important secondary injury factor after TBI with hyperphosphorylation of tau promoting its aggregation into oligomers, which are thought to act as seeds for further tau pathology and ongoing neuronal cell injury,” the study authors said.
The findings will potentially have significant implications for athletes who play contact sports – such as boxers and footballers – as well as military veterans sustaining head injuries in conflict.
While the treatment was successfully tested in animal models, human clinical trials could take several years given that currently CTE can only be diagnosed post-mortem.
More research required on gadolinium-enhanced MRI re: blood-labyrinth barrier
Researchers have found no conclusive evidence to support the assumption that gadolinium can be used to directly measure the health of the blood-labyrinth barrier.
A systematic review of the evidence found gadolinium-based contrast agents (GBCA) cross the blood-labyrinth barrier in healthy ears and more rapidly in some diseased ears.
And pathologies such as idiopathic sudden sensorineural hearing loss (ISSHL), Ménière’s disease, otosclerosis, and vestibular schwannoma have been shown to alter the intensity of signal on MRI.
However, “Although abnormal enhancement was well-described by most studies, there were conflicting reports of correlations between this enhancement and clinical characteristics such as prognosis and disease severity,” the study said.
They said it was currently impossible to make a reliable comparison of blood-labyrinth barrier permeability in different disease states.