Effects of Cerebrospinal Fluid AMPA Receptor Levels on the Clinical Efficacy of Lamotrigine in Epilepsy Treatment

Abstract

Background: Epilepsy is one of the greatest health burdens in the world, and it deeply impacts the mental and physical health of the affected population. Some individuals can completely recover through effective treatment, while others have difficulty recovering and even have mortality risks during seizure attacks. Thus, we explored the effects of cerebrospinal fluid AMPA receptor levels on the clinical efficacy of lamotrigine in epilepsy treatment. We believe our work might have implications in epilepsy treatment. Methods: Seventy cases of epilepsy diagnosed in our hospital were selected for this study from December 2016 to October 2018. The AMPA receptor content of patients in cerebrospinal fluid was determined by enzyme-linked immunosorbent assay. The patients were placed into a high AMPA group (n=34) and a low AMPA group (n=36) according to the median value at 4.08 ng/ml. Clinical efficacy and the incidence of adverse reactions were compared between the two groups. Results: Before treatment, there was no significant difference in seizure frequency between the two groups (P>0.05). After treatment for 6 and 12 months, the seizure frequencies of the two groups were gradually reduced (P<0.05). Moreover, the number of seizures in the low AMPA group was significantly lower than that in the high AMPA group (P<0.05). The response rate of the high AMPA group was 79.41%, which was significantly lower than that of the low group AMPA (χ2=6.055, P=0.048). The improvement in electroencephalogram in the high AMPA group was 67.65%, which was significantly lower than that in the low AMPA group (χ2=4.686, P=0.030). However, there was no significant difference in the incidence of adverse reactions between the two groups (χ2=0.202, P=0.653). Conclusions: AMPA receptor plays an important role in the development of epilepsy, and lamotrigine treatment was more efficacious in patients with low AMPA receptor levels.