Association between the Serum Coenzyme Q10 Level and Seizure Control in Patients with Drug-Resistant Epilepsy.

Wei-Chen Liao,Chin-Wei Huang,Pi-Shan Sung,Hui Hua Chang,Ya-Hsin Hsiao,Tzu-Fun Fu,Alice Y W Chang

doi:10.3390/healthcare9091118

Abstract

Drug-resistant epilepsy (DRE) is a chronic neurological disorder with somatic impacts and increased risk of metabolic comorbidities. Oxidative stress might play an important role in metabolic effects and as a regulator of seizure control, while coenzyme Q10 (CoQ10) could improve insulin sensitivity through antioxidant effects. We aimed to investigate the association between CoQ10 level and clinical outcome, represented by the seizure frequency and quality of life, in DRE patients. DRE patients (N = 33) had significantly higher serum insulin levels and lower scores on the physical domain of the World Health Organization Quality of Life questionnaire (WHOQoL) than gender-age matched controls. The serum CoQ10 level (2910.4 ± 1163.7 ng/mL) was much higher in DRE patients than the normal range. Moreover, the serum CoQ10 level was significantly correlated with the seizure frequency (r = −0.412, p = 0.037) and insulin level (r = 0.409, p = 0.038). Based on stratification by insulin resistance (HOMA-IR > 2.4), the subgroup analysis showed that patients with a greater HOMA-IR had higher CoQ10 levels and lower seizure frequency, and had a significantly worse quality of life. In summary, CoQ10 could be a mediator involved in the mechanism of epilepsy and serve as a biomarker of the clinical outcome in DER patients.

Highlights

The serum coenzyme Q10 (CoQ10) level (2910.4 ± 1163.7 ng/mL) was much higher in drug-resistant epilepsy (DRE) patients than the normal range in the general population (360~1590 ng/mL) [30], while the Creatine Phosphokinase (CPK) level was within the normal range (Table 1)
The results indicate that an improved understanding of the possible shared mechanism involved in epilepsy, glucose metabolism, insulin signaling, and the actions of antiepileptic drugs (AEDs) could contribute to the design of therapies targeting molecules besides those targeted by typical ion channel AEDs
The study demonstrated that DRE patients had increases in CoQ10 levels and insulin profiles and a worse health-related quality of life than controls

Summary

Introduction

Epilepsy is a chronic neurological disorder caused by malfunctioning nerve cell activity in the brain, which is characterized by recurrent episodic attacks, epileptic seizures, and somatic impacts [1]. Somatic conditions such as metabolic syndromes, arthritis, and heart diseases have been linked to epilepsy [2,3,4]. The management of patients with epilepsy is focused on controlling seizures, avoiding treatment side effects, and restoring quality of life. There are expanding lists of available antiepileptic drugs (AEDs), approximately 30% of people who continue to have seizures after adequate trials of two AED treatments develop drug-resistant epilepsy (DRE) [5,6].

Objectives

Methods

Results

Discussion

Conclusion