Chinese Pediatrics of Integrated Traditional and Western Medicine ›› 2020, Vol. 12 ›› Issue (1): 79-83.doi: 10.3969/j.issn.1674-3865.2020.01.022
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Abstract: Objective To evaluate the effect of vagal nerve stimulation(VNS) on tryptophan metabolite in plasma,and investigate whether the antiepileptic effectiveness is correlated with changes in tryptophan metabolism Methods Sixty children with intractable epilepsy were included in a randomized,doubleblind study,and were divided into highoutput stimulation group and lowoutput group,30 cases in each group After a baseline period of 12 weeks,all children underwent implantation of a vagus nerve stimulator and entered a double blind activecontrolled phase of 20 weeks Subsequently,all children received highoutput stimulation for another 19 weeks (addon phase) Tryptophan metabolites were assessed in plasma by liquid chromatographytandem mass spectrometry (LC-MS/MS) and analysed in different study stages Seizure frequency was recorded using seizure diaries Mood was assessed using Profile of Mood States(POMS) questionnaires Results Regarding tryptophan metabolites in plasma,anthranilic acid(AA) levels were significantly higher at the end of the addon phase compared with baseline(P=0002),and were correlated significantly with improvement of mood(r=0.37,P=0.042) and seizure frequency reduction(r=0.35,P<0.01) No significant differences were found between high and lowoutput groups regarding seizure frequency Conclusion Vagus nerve stimulation may induces a consistent increase in AA,a neuroprotective and anticonvulsant tryptophan metabolite Moreover,increased AA levels are probably associated with improvement in mood and reduction of seizure frequency
Key words: Intractable seizures, Vagal nerve stimulation, Tryptophan metabolism, Anthranilic acid, Profile of mood states
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https://www.zxek.net/EN/Y2020/V12/I1/79