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Srpski arhiv za celokupno lekarstvo
2019, vol. 147, br. 3-4, str. 193-1998
jezik rada: srpski
vrsta rada: originalan članak
doi:10.2298/SARH171225066M


Uticaj topiramata na kognitivne funkcije bolesnika sa fokalnom epilepsijom - studija praćenja u srpskom uzorku
aUniversity of Priština - Kosovska Mitrovica, Faculty of Medicine, Kosovska Mitrovica + Priština Clinical-hospital Center, Gračanica
bUniverzitet u Beogradu, Medicinski fakultet, Klinički centar Srbije
cUniverzitet u Prištini (Kosovska Mitrovica), Medicinski fakultet
dUniverzitet u Beogradu, Medicinski fakultet

e-adresa: mmnenad@yahoo.com

Sažetak

Uvod/Cilj Cilj ove studije bio je da se utvrdi efekat topiramata na kognitivne funkcije bolesnika sa farmakorezistentnom fokalnom epilepsijom. Metode Studija je obuhvatila 40 bolesnika koji ranije nisu lečeni topiramatom. Početna doza topiramata bila je 25 mg, sa brzinom povećanja doze od 25 mg na svakih 14 dana. Širok spektar kognitivnih funkcija procenjen je obimnim neuropsihološkim testiranjem u dva odvojena intervala, pre nego što je uveden topiramat i šest meseci posle dostizanja ciljne doze (200 mg/dan). Rezultati Najčešći neželjeni efekti posle uvođenja topiramata bile su kognitivne smetnje, koje je prijavilo 45% bolesnika. Neuropsihološki skorovi dobijeni posle uvođenja topiramata su znatno niži nego pre topiramata na merenjima pažnje, egzekutivnih funkcija, prisećanja verbalnog sadržaja, brzine kognitivne fleksibilnosti, kao i vizuospacijalne sposobnosti i govora. Međutim, nije nađena značajna korelacija između neuropsiholoških skorova i broja antiepileptičkih lekova dodatih topiramatu. Pored toga, nije nađena značajna razlika u učestalosti pogoršanja neuropsiholoških skorova između bolesnika sa nižim i višim bazičnim kognitivnim performansama. Takođe, vrednost procenatne promene na većini kognitivnih merenja nije značajno povezana sa godinama na početku epilepsije, trajanjem epilepsije, prisustvom moždanih lezija vidljivih na nuklearnoj magnetnoj rezonanci i procentualnom promenom na skali depresije. Zaključak Uprkos postepenom uvođenju i primeni relativno niskih doza, topiramat izaziva neželjene efekte na širok spektar kognitivnih funkcija, čija pojava nije povezana sa brojem dodatih antiepileptičkih lekova, bazičnim kognitivnim funkcionisanjem, uzrastom na početku epilepsije i njenim trajanjem, prisustvom moždanih lezija i stepenom depresije.

Ključne reči

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