Comparison of the effects of felbamate and levatiracetam with respect to immunologic, histologic and oxidative changes after traumatic brain injury

Objective: Our objective in this study is to compare effects of antiepileptic agents felbamate, which has inadequate information in literature, and levatiracetam; immunologically, histologically and in response to oxidative stress after head trauma in rats. Materials and Methods: In this study, we used 32 Sprague-Dawley male rats, ranging between 6-8 weeks age and 250-300 grams weight. Our head trauma model setup consisted of a 450 g mass, dropped from a height of 1 meter with 90 degrees angle, on to the parietal region and thereby resulting in a closed head trauma. Rats were grouped into 4 seperate groups with each containing 8 rats. First group were subjected to head trauma and given saline; second group were subjected to head trauma and given levatiracetam at a 50 mg/kg dose; third group were subjected to head trauma and given Felbamate at a 100 mg/kg dose; fourth group were subjected to head trauma and given Levatiracetam at a 50 mg/kg dose and Felbamate at a 100 mg/kg dose; intraperitoneal, once a day for 20 days. After 20 days, rats were decapitated and blood samples taken were inspected biochemically; tissue samples were inspected immunohistochemically and histopathologically. Results: Serum cytokine levels were increased after trauma in; control, Levatiracetam, Felbamate and Levatiracetam + Felbamate groups. Generally, cytokine levels of Levetiracetam, Felbamate and Levetiracetam + Felbamate groups were lower, compared to control group with Felbamate + Levatiracetam group having lowest cytokine levels. As an indication of oxidative injury Tiyobarbiturate reactive species (TBARS) level was significantly higher after trauma in control group, compared to others and also members of antioxidant defense system; reduced glutathione (GSH), superoxide dismutase (SOD), glutathione peroxidase (GPx), and catalase (CAT) were all reduced significantly (P<0.01). After treatment with medication, all medication groups showed elevated GSH, SOD, CAT and GPx levels and highest increase in SOD and GPx was in Levatiracetam + Felbamate group. Conclusions: We found that after head trauma in rats, from a perspective of histologic, immunologic and biochemical parameters, Levatiracetam and Felbamate were beneficial in neurologic recovery on their own immunologically, histologically and with respect to oxidative changes; but the best results were acquired in the group that were given Levatiracetam and Felbamate together. Key Words: Head Trauma, Felbamate, Levatiracetam