Unraveling the neuroprotective effect of perampanel and lacosamide combination in the corneal kindling model for epilepsy in mice

Saba Tehreem , Azka Sabir , Maryam Farooq , Waseem Ashraf , Faleh Alqahtani , Tanveer Ahmad , Imran Imran

Animal Models and Experimental Medicine ›› 2025, Vol. 8 ›› Issue (2) : 222 -238.

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Animal Models and Experimental Medicine ›› 2025, Vol. 8 ›› Issue (2) : 222 -238. DOI: 10.1002/ame2.12524
ORIGINAL ARTICLE

Unraveling the neuroprotective effect of perampanel and lacosamide combination in the corneal kindling model for epilepsy in mice

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Abstract

Background: Scientific evidence to guide clinicians on the use of different antiseizure drugs in combination therapy is either very limited or lacking. In this study, the impact of lacosamide and perampanel alone and in combination was tested in corneal kindling model in mice, which is a cost-effective mechanism for screening of antiseizure drugs.

Methods: The impact of lacosamide (5mg/kg) and perampanel (0.125mg/kg) alone and their combination was tested in corneal kindling process (3-mA current for 3s applied twice daily for consecutive 12days) in male BALB/c mice. Post-kindling, mice were subjected to a battery of behavioral tests assessing anxiety, memory, and depression-like behaviors. Brain tissues were then harvested for analysis of oxidative stress biomarkers.

Results: Our results showed that the combination therapy of lacosamide and perampanel was more effective in reducing seizure progression than monotherapy of these drugs. Animals treated with combination therapy showed significant behavioral improvements, as reduced anxiety and depression were noticed, and their cognitive abilities were notably better compared to animals of all other groups. Moreover, biochemical assays of isolated brains from combination-treated group revealed lesser amount of oxidative stress. In addition, outcomes of dual regime were comparable to the phenytoin in seizure control but showed superior benefits in mitigation of kindling-prompted behavioral dysfunction and oxidative stress.

Conclusions: This study suggests that the lacosamide and perampanel combination therapy worked noticeably better in halting the corneal kindling process in mice and improved the epilepsy-associated psychiatric disorders that might be due to antioxidant effects of both drugs.

Keywords

behavioral studies / corneal kindling / lacosamide / learned helplessness / oxidative stress / perampanel

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Saba Tehreem, Azka Sabir, Maryam Farooq, Waseem Ashraf, Faleh Alqahtani, Tanveer Ahmad, Imran Imran. Unraveling the neuroprotective effect of perampanel and lacosamide combination in the corneal kindling model for epilepsy in mice. Animal Models and Experimental Medicine, 2025, 8(2): 222-238 DOI:10.1002/ame2.12524

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References

[1]

Thijs RD, Surges R, O’Brien TJ, Sander JW. Epilepsy in adults. Lancet (London, England). 2019;393(10172):689-701.

[2]

Stafstrom CE, Carmant L. Seizures and epilepsy: an overview for neuroscientists. Cold Spring Harb Perspect Med. 2015;5(6):1-19.

[3]

Fisher RS, Acevedo C, Arzimanoglou A, et al. ILAE official report: a practical clinical definition of epilepsy. Epilepsia. 2014;55(4):475-482.

[4]

Beghi E. The epidemiology of epilepsy. Neuroepidemiology. 2020;54(2):185-191.

[5]

Espinosa-Jovel C, Toledano R, Aledo-Serrano Á, García-Morales I, Gil-Nagel A. Epidemiological profile of epilepsy in low income populations. Seizure. 2018;56:67-72.

[6]

Kanner AM. Suicidality in patients with epilepsy: why should neurologists care? Front Integr Neurosci. 2022;16:1-8.

[7]

Keezer MR, Sisodiya SM, Sander JW. Comorbidities of epilepsy: current concepts and future perspectives. Lancet Neurol. 2016;15(1):106-115.

[8]

Seidenberg M, Pulsipher DT, Hermann B. Association of epilepsy and comorbid conditions. Future Neurol. 2009;4(5):663-668.

[9]

Verrotti A, Striano P, Iapadre G, et al. The pharmacological management of Lennox-Gastaut syndrome and critical literature review. Seizure. 2018;63:17-25.

[10]

Kwan P, Brodie MJ. Early identification of refractory epilepsy. N Engl J Med. 2000;342(5):314-319.

[11]

Mula M. Third generation antiepileptic drug monotherapies in adults with epilepsy. Expert Rev Neurother. 2016;16(9):1087-1092.

[12]

Hoy SM. Lacosamide: a review in focal-onset seizures in patients with epilepsy. CNS Drugs. 2018;32(5):473-484.

[13]

Verrotti A, Loiacono G, Pizzolorusso A, et al. Lacosamide in pediatric and adult patients: comparison of efficacy and safety. Seizure. 2013;22(3):210-216.

[14]

Hanaya R, Arita K. The new antiepileptic drugs: their neuropharmacology and clinical indications. Neurol Med Chir (Tokyo). 2016;56(5):205-220.

[15]

Kellerman RD, Rakel D. Conn’s Current Therapy. Elsevier; 2023. Accessed March 14, 2023. https://www.meripustak.com/Conn-s-Current-Therapy-2023-1st-Edition-391597

[16]

Potschka H, Löscher W. Corneal kindling in mice: behavioral and pharmacological differences to conventional kindling. Epilepsy Res. 1999;37(2):109-120.

[17]

Sato M, Racine RJ, McIntyre DC. Kindling: basic mechanisms and clinical validity. Electroencephalogr Clin Neurophysiol. 1990;76(5):459-472.

[18]

White HS, Johnson M, Wolf HH, Kupferberg HJ. The early identification of anticonvulsant activity: role of the maximal electroshock and subcutaneous pentylenetetrazol seizure models. Ital J Neurol Sci. 1995;16(1–2):73-77.

[19]

Löscher W. Animal models of epilepsy and epileptic seizures. In: Eadie MJ, Vajda FJE, eds. Antiepileptic Drugs. Handbook of Experimental Pharmacology. Vol 138. Springer; 1999.

[20]

Matagne A, Klitgaard H. Validation of corneally kindled mice: a sensitive screening model for partial epilepsy in man. Epilepsy Res. 1998;31(1):59-71.

[21]

Sarhan EM, Walker MC, Selai C. Evidence for efficacy of combination of antiepileptic drugs in treatment of epilepsy. J Neurol Res. 2015;5(6):267-276.

[22]

Stöhr T, Kupferberg HJ, Stables JP, et al. Lacosamide, a novel anti-convulsant drug, shows efficacy with a wide safety margin in rodent models for epilepsy. Epilepsy Res. 2007;74(2–3):147-154.

[23]

Franco V, Crema F, Iudice A, Zaccara G, Grillo E. Novel treatment options for epilepsy: focus on perampanel. Pharmacol Res. 2013;70(1):35-40.

[24]

Charan J, Kantharia N. How to calculate sample size in animal studies? J Pharmacol Pharmacother. 2013;4(4):303-306.

[25]

Malik N, Javaid S, Ashraf W, et al. Long-term supplementation of Syzygium cumini (L.) Skeels concentrate alleviates age-related cognitive deficit and oxidative damage: a comparative study of young vs. old mice. Nutrients. 2023;15(3):1-28.

[26]

Malik H, Javaid S, Rasool MF, et al. Amelioration of scopolamine-induced amnesic, anxiolytic and antidepressant effects of ficus benghalensis in behavioral experimental models. Medicina (Kaunas). 2020;56(3):1-17.

[27]

Chen D, Wang J, Xing Y, et al. Behavioral assessment of post-stroke depression and anxiety in rodents. Brain Hemorrhages. 2020;1(2):105-111.

[28]

Imran I, Javaid S, Waheed A, et al. Grewia asiatica berry juice diminishes anxiety, depression, and scopolamine-induced learning and memory impairment in behavioral experimental animal models. Front Nutr. 2021;7:7.

[29]

Rehman Z, Farooq T, Javaid S, et al. Combination of levetiracetam with sodium selenite prevents pentylenetetrazole-induced kindling and behavioral comorbidities in rats. Saudi Pharm J. 2022;30(5):494-507.

[30]

Javaid S, Alqahtani F, Ashraf W, et al. Tiagabine suppresses pentylenetetrazole-induced seizures in mice and improves behavioral and cognitive parameters by modulating BDNF/TrkB expression and neuroinflammatory markers. Biomed Pharmacother. 2023;160:114406.

[31]

Shakeel W, Javaid S, Anjum SMM, et al. Time course evaluation of lacosamide alone and in polypharmacy on behavioral manifestations and oxidative stress in lithium-pilocarpine-induced model. J Physiol Pharmacol. 2020;71(4):547-564. doi:10.26402/JPP.2020.4.10

[32]

Javaid U, Javaid S, Ashraf W, et al. Chemical profiling and dose-dependent assessment of fear reducing and memory-enhancing effects of Solanum virginianum in rats. Dose-Response. 2021;19(1):1-18.

[33]

Medina-Rodriguez EM, Madorma D, O’Connor G, et al. Identification of a signaling mechanism by which the microbiome regulates Th17 cell-mediated depressive-like behaviors in mice. Am J Psychiatry. 2020;177(10):974-990.

[34]

Liu MY, Yin CY, Zhu LJ, et al. Sucrose preference test for measurement of stress-induced anhedonia in mice. Nat Protoc. 2018;13(7):1686-1698.

[35]

Gaweł S, Wardas M, Niedworok E, Wardas P. Malondialdehyde (MDA) as a lipid peroxidation marker. Wiad Lek. 2004;57(9–10):453-455. Accessed July 10, 2023. https://europepmc.org/article/med/15765761

[36]

Aguiar CCT, Almeida AB, Arajo PVP, et al. Oxidative stress and epilepsy. Literature review. Oxidative Med Cell Longev. 2012;2012:1-12.

[37]

Huang Q, Liao C, Ge F, Ao J, Liu T. Acetylcholine bidirectionally regulates learning and memory. J Neuro-Oncol. 2022;10(2):100002.

[38]

Gnatek Y, Zimmerman G, Goll Y, Najami N, Soreq H, Friedman A. Acetylcholinesterase loosens the brain’s cholinergic anti-inflammatory response and promotes epileptogenesis. Front Mol Neurosci. 2012;5:66.

[39]

Reynolds EH, Shorvon SD. Monotherapy or poly therapy for epilepsy? Epilepsia. 1981;22(1):1-10.

[40]

Olsen RW, Avoli M. GABA and epileptogenesis. Epilepsia. 1997;38(4):399-407.

[41]

Czuczwar SJ, Patsalos PN. The new generation of GABA enhancers. Potential in the treatment of epilepsy. CNS Drugs. 2001;15(5):339-350.

[42]

Kwan P, Brodie MJ. Effectiveness of first antiepileptic drug. Epilepsia. 2001;42(10):1255-1260.

[43]

Perucca E. Pharmacological principles as a basis for polytherapy. Acta Neurol Scand. 1995;92:31-34.

[44]

Genton P, Roger J. Antiepileptic drug monotherapy versus poly therapy: a historical perspective. Epilepsia. 1997;38(SUPPL. 5):S2-S5.

[45]

Cavazos JE, Sutula TP. Progressive neuronal loss induced by kindling: a possible mechanism for mossy fiber synaptic reorganization and hippocampal sclerosis. Brain Res. 1990;527(1):1-6.

[46]

Sendrowski K, Sobaniec W. Hippocampus, hippocampal sclerosis and epilepsy. Pharmacol Rep. 2013;65(3):555-565.

[47]

Lamont SR, Paulls A, Stewart CA. Repeated electroconvulsive stimulation, but not antidepressant drugs, induces mossy fibre sprouting in the rat hippocampus. Brain Res. 2001;893(1–2):53-58.

[48]

Loewen JL, Barker-Haliski ML, Jill Dahle E, Steve White H, Wilcox KS. Neuronal injury, gliosis, and glial proliferation in two models of temporal lobe epilepsy. J Neuropathol Exp Neurol. 2016;75(4):366-378.

[49]

Wu MF, Lim WH, Pharm B, Pharm C. Phenytoin: a guide to therapeutic drug monitoring. Proceedings of Singapore Healthcare. 2013;22(3):198-202.

[50]

Patocka J, Wu Q, Nepovimova E, Kuca K. Phenytoin—an anti-seizure drug: overview of its chemistry, pharmacology and toxicology. Food Chem Toxicol. 2020;142:1-8.

[51]

Hanada T, Hanada T. The AMPA receptor as a therapeutic target in epilepsy: preclinical and clinical evidence. J Receptor Ligand Channel Res. 2014;7:39-50.

[52]

Lee K, Goodman L, Fourie C, Schenk S, Leitch B, Montgomery JM. AMPA receptors as therapeutic targets for neurological disorders. Adv Protein Chem Struct Biol. 2016;103:203-261.

[53]

Hanada T, Hashizume Y, Tokuhara N, et al. Perampanel: a novel, orally active, noncompetitive AMPA-receptor antagonist that reduces seizure activity in rodent models of epilepsy. Epilepsia. 2011;52(7):1331-1340.

[54]

Russmann V, Salvamoser JD, Rettenbeck ML, Komori T, Potschka H. Synergism of perampanel and zonisamide in the rat amygdala kindling model of temporal lobe epilepsy. Epilepsia. 2016;57(4):638-647.

[55]

Doty P, Hebert D, Mathy FX, Byrnes W, Zackheim J, Simontacchi K. Development of lacosamide for the treatment of partial-onset seizures. Ann N Y Acad Sci. 2013;1291(1):56-68.

[56]

Tariq M, Javaid S, Ashraf W, et al. Unveiling the potential of perampanel and pregabalin in addressing pentylenetetrazole-induced electrographic alterations and neurobehavioral anomalies. Biomed Pharmacother. 2024;170:115935.

[57]

Jackson MJ, Turkington D. Depression and anxiety in epilepsy. J Neurol Neurosurg Psychiatry. 2005;76(suppl 1):i45-i47.

[58]

Bektas N, Arslan R, Alyu F. The anxiolytic effect of perampanel and possible mechanisms mediating its anxiolytic effect in mice. Life Sci. 2020;261:261.

[59]

Higgins GA, Breysse N, Undzys E, et al. The anti-epileptic drug lacosamide (Vimpat) has anxiolytic property in rodents. Eur J Pharmacol. 2009;624(1–3):1-9.

[60]

Eddy CM, Rickards HE, Cavanna AE. The cognitive impact of antiepileptic drugs. Ther Adv Neurol Disord. 2011;4(6):385-407.

[61]

Shishmanova-Doseva M, Peychev L, Yoanidu L, et al. Anticonvulsant effects of topiramate and Lacosamide on pilocarpine-induced status epilepticus in rats: a role of reactive oxygen species and inflammation. Int J Mol Sci. 2021;22(5):1-13.

[62]

Wang T, Wang L, Li L, Ma L, Liu X. Effects of perampanel on cognitive behavior and GluR1 expression in immature mice of temporal lobe epilepsy. Biochem Biophys Res Commun. 2022;588:68-74.

[63]

Kanner AM. Depression in epilepsy: prevalence, clinical semiology, pathogenic mechanisms, and treatment. Biol Psychiatry. 2003;54(3):388-398.

[64]

Goji H, Kanemoto K. The effect of perampanel on aggression and depression in patients with epilepsy: a short-term prospective study. Seizure. 2019;67:1-4.

[65]

Citraro R, Aiello R, Franco V, De Sarro G, Russo E. Targeting α-amino-3-hydroxyl-5-methyl-4-isoxazole-propionate receptors in epilepsy. Expert Opin Ther Targets. 2014;18(3):319-334.

[66]

Rocamora R, Ley M, Molins A, et al. Effect of lacosamide on depression and anxiety symptoms in patients with focal refractory epilepsy: a prospective multicenter study. Epilepsy Behav. 2018;79:87-92.

[67]

Toniolo S, Di Lorenzo F, Bozzali M, Yogarajah M. The impact of lacosamide on mood disorders in adult patients with epilepsy: a systematic review. Epilepsy Behav. 2020;111:111.

[68]

Scharfman HE. The neurobiology of epilepsy. Curr Neurol Neurosci Rep. 2007;7(4):348-354.

[69]

Koshal P, Kumar P. Effect of liraglutide on corneal kindling epilepsy induced depression and cognitive impairment in mice. Neurochem Res. 2016;41(7):1741-1750.

[70]

Łukawski K, Czuczwar SJ. Oxidative stress and neurodegeneration in animal models of seizures and epilepsy. Antioxidants. 2023;12(5):1049.

[71]

Lazzarotto L, Pflüger P, Regner GG, et al. Lacosamide improves biochemical, genotoxic, and mitochondrial parameters after PTZ-kindling model in mice. Fundam Clin Pharmacol. 2021;35(2):351-363.

[72]

Chen T, Dai SH, Jiang ZQ, et al. The AMPAR antagonist Perampanel attenuates traumatic brain injury through anti-oxidative and anti-inflammatory activity. Cell Mol Neurobiol. 2017;37(1):43-52.

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2025 The Author(s). Animal Models and Experimental Medicine published by John Wiley & Sons Australia, Ltd on behalf of The Chinese Association for Laboratory Animal Sciences.

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