Выпуск 6-10, 2020
Обзорная статья
Механизмы действия и безопасность физических упражнений у больных с эпилепсией (обзор)
1 Петров К.В., 1 Петрова М.М., 1,2 Шнайдер Н.А., 2 Насырова Р.Ф.
1 Красноярский государственный медицинский университет им. В. Ф. проф. Войно-Ясенецкого Минздрава России, Красноярск, Россия
2 Национальный медицинский исследовательский центр психиатрии и неврологии им. В. М. Бехтерева Минздрава России, Санкт-Петербург, Россия
РЕЗЮМЕ
Юношеская миоклоническая эпилепсия (ЮМЭ) является распространенной формой генетической генерализованной эпилепсии. Интеллект и физическое развитие пациентов не страдают. Однако эпилепсия характеризуется высоким уровнем социальной стигматизации. Это является причиной необоснованных ограничений и низкой физической активности пациентов.В обзоре рассмотрены механизмы действия физических упражнений на головной мозг при эпилепсии, включая преимуществафизических упражнений для предотвращения приступов. Физическая активность при эпилепсии обеспечивает механизмызащиты нейронов, связанные с биохимическими и структурными изменениями, включая высвобождение β-эндорфинов и нейростероидов, которые могут оказывать ингибирующее действие на возникновение аномальной (пароксизмальной) электрической активности головного мозга. Эпилептиформная активность на электроэнцефалограмме может уменьшаться или исчезать во время физических упражнений, что может привести к уменьшению риска повторения эпилептических приступов.Хотя, у некоторых пациентов физические упражнения могут вызвать эпилептические приступы, их риск не превышает 2–10%и ниже при ЮМЭ. Программы реабилитации, способствующие развитию физических упражнений у подростков и пациентовмолодого возраста с эпилепсией, должны быть направлены на улучшение их физического, психологического и социальногоблагополучия.
КЛЮЧЕВЫЕ СЛОВА: эпилепсия, юношеская миоклоническая эпилепсия (ЮМЭ), физические упражнения, физические тренировки, физическая активность, спорт, эффективность, безопасность, качество жизни, электроэнцефалография
ДЛЯ ЦИТИРОВАНИЯ: Петров К.В., Петрова М.М., Шнайдер Н.А., Насырова Р.Ф. Механизмы действия и безопасность физических упражнений у больных с эпилепсией (обзор). Вестник восстановительной медицины. 2020; 6 (100): 81–91. https://doi.org/10.38025/2078-1962-2020-100-6-81-91
Список литературы:
- Карлов В.А., Фрейдкова Н.В. Юношеская миоклоническая эпилепсия. Эпилепсия у детей и взрослых женщин и мужчин. М. Медицина. 2010.
- Shawahna R., Abdelhaq I. Important knowledge items with regard to the benefits of exercise for patients with epilepsy: Findings of a qualitative study from Palestine. Epilepsy & Behavior. 2020; (108): 107099. https://doi.org/10.1016/j.yebeh.2020.107099
- Elliott J.O., Moore J.L., Lu B. Health status and behavioral risk factors among persons with epilepsy in Ohio based on the 2006 Behavioral Risk Factor Surveillance System. Epilepsy & Behavior. 2008; 12(3): 434-444. https://doi.org/10.1016/j.yebeh.2007.12.001
- Ablah E., Haug A., Konda K., Tinius A.M., Ram S., Sadler T., Liow K. Exercise and epilepsy: a survey of Midwest epilepsy patients. Epilepsy & Behavior. 2009; 14(1): 162-166. https://doi.org/10.1016/j.yebeh.2008.09.019
- Cui W., Zack M.M., Kobau R., Helmers S.L. Health behaviors among people with epilepsy—results from the 2010 National Health Interview Survey. Epilepsy & Behavior. 2015; (44): 121-126. https://doi.org/10.1016/j.yebeh.2015.01.011
- Chong J., Kudrimoti H.S., Lopez D.C., Labiner D.M. Behavioral risk factors among Arizonans with epilepsy: Behavioral Risk Factor Surveillance System 2005/2006. Epilepsy & Behavior. 2010; 17(4): 511-519. https://doi.org/10.1016/j.yebeh.2010.01.165
- Elliott J.O., Lu B., Moore J.L., McAuley J.W., Long L. Exercise, diet, health behaviors, and risk factors among persons with epilepsy based on the California Health Interview Survey, 2005. Epilepsy & Behavior. 2008; 13(2): 307-315. https://doi.org/10.1016/j.yebeh.2008.04.003
- Hinnell C., Williams J., Metcalfe A., Patten S.B., Parker R., Wiebe S., Jette N. Health status and health-related behaviors in epilepsy compared to other chronic conditions—a national population-based study: health status and behaviors in epilepsy. Epilepsia. 2010; 51(5): 853-861. https://doi.org/10.1111/ j.1528-1167.2009.02477.x
- Wong J., Wirrell E. Physical activity in children/teens with epilepsy compared with that in their siblings without epilepsy. Epilepsia. 2006; 47(3): 631-639. https://doi.org/10.1111/j.1528-1167.2006.00478.x
- Gordon K.E., Dooley J.M., Brna P.M. Epilepsy and activity—a population-based study: epilepsy and activity. Epilepsia. 2010; 51(11): 2254-2259. https:// doi.org/10.1111/j.1528-1167.2010.02709.x
- Arida R.M., Scorza F.A., de Albuquerque M., Cysneiros R.M., de Oliveira R.J., Cavalheiro E.A. Evaluation of physical exercise habits in Brazilian patients with epilepsy. Epilepsy & Behavior. 2003; 4(5): 507-510. https://doi.org/10.1016/s1525-5050(03)00184-7
- Nakken K.O. Physical exercise in outpatients with epilepsy. Epilepsia. 1999; 40(5): 643-651. https://doi.org/10.1111/j.1528-1157.1999.tb05568.x
- Steinhoff BJ., Neususs K., Thegeder H., Reimers C.D. Leisure time activity and physical fitness in patients with epilepsy. Epilepsia. 1996; 37(12): 12211227. https://doi.org/10.1111/j.1528-1157.1996.tb00557.x
- Jalava M., Sillanpaa M. Physical activity, health-related fitness, and health experience in adults with childhood-onset epilepsy: a controlled study. Epilepsia. 1997; 38(4): 424-429. https://doi.org/10.1111/j.1528-1157.1997.tb01731.x
- Engel-Yeger B., Zlotnik S., Shahar E. Childhood-onset primary generalized epilepsy—impacts on children’s preferences for participation in out-of-school activities. Epilepsy & Behavior. 2014; 34(1): 1-5. https://doi.org/10.1016/j.yebeh.2014.02.021
- Han K., Choi-Kwon S., Lee S-K. Leisure time physical activity in patients with epilepsy in Seoul, South Korea. Epilepsy & Behavior. 2011; 20(2): 321-325. https://doi.org/10.1016/j.yebeh.2010.11.018
- Saengsuwan J., Boonyaleepan S., Tiamkao S. Diet, exercise, sleep, sexual activity, and perceived stress in people with epilepsy in NE Thailand. Epilepsy & Behavior. 2015; 45: 39-43. https://doi.org/10.1016/j.yebeh.2015.02.014
- Carrizosa-Moog J., Ladino L.D., Benjumea-Cuartas V., Orozco-Hernandez J.P., Castrillon-Velilla D.M., Rizvi S., Francisco Tellez-Zenteno J.F. Epilepsy, Physical Activity and Sports: A Narrative Review. The Canadian Journal of Neurological sciences. 2018; 45(6): 624-632. https://doi.org/10.1017/cjn.2018.340
- Epps S.A., Kahn A.B., Holmes P.V., Boss-Williams K.A., Weiss J.M., Weinshenker D. Antidepressant and anticonvulsant effects of exercise in a rat model of epilepsy and depression comorbidity. Epilepsy & Behavior. 2013; 29(1): 47-52. https://doi.org/10.1016/j.yebeh.2013.06.02
- Lerner J.T., Sankar R., Mazarati A.M. Galanin and epilepsy. Experientia Supplementum. 2010; 102: 183-194. https://doi.org/10.1007/978-3-0346-0228-0_13
- De Lima C., de Lira C.A.B., Arida R.M., Andersen M.L., Matos G., de Figueiredo Ferreira Guilhoto L.M., Yacubian E.M.T., de Albuquerque M., Tufik S., dos Santos Andrade M.,Vancini R.L. Association between leisure time, physical activity, and mood disorder levels in individuals with epilepsy. Epilepsy & Behavior. 2013; 28(1): 47-51. https://doi.org/10.1016/j.yebeh.2013.03.016
- Vancini R.L., de Lira C.A.B., Scorza F.A., de Albuquerque M., Sousa B.S., de Lima C., Cavalheiro E.A., da Silva A.C., Arida R.M. Cardiorespiratory and electroencephalographic responses to exhaustive acute physical exercise in people with temporal lobe epilepsy. Epilepsy & Behavior. 2010; 19(3): 504-508. https://doi.org/10.1016/j.yebeh.2010.09.007
- Kim J., Jung D.S., Hwang K.J., Seo J-H., Na G-Y., Hong S.B., Joo E.Y., Seo D-W. Can an exercise bicycle be safely used in the epilepsy monitoring unit? An exercise method to provoke epileptic seizures and the related safety issues. Epilepsy & Behavior. 2015; (46): 79-83. https://doi.org/10.1016/j.ye-beh.2015.04.049
- McAuley J.W., Long L., Heise J., Kirby T., Buckworth J., Pitt C., Lehman K.J, Moore J.L., Reeves A.L. A prospective evaluation of the effects of a 12-week outpatient exercise program on clinical and behavioral outcomes in patients with epilepsy. Epilepsy & Behavior. 2001; 2(6): 592-600. https://doi. org/10.1006/ebeh.2001.0271
- Roth D.L., Goode K.T., Williams V.L., Faught E. Physical exercise, stressful life experience, and depression in adults with epilepsy. Epilepsia. 1994; 35(6): 1248-1255. https://doi.org/10.1111/j.1528-1157.1994.tb01796.x
- Eom S., Lee M.K., Park J-H., Jeon J.Y., Kang H-C., Lee J.S., Kim H.D. The impact of an exercise therapy on psychosocial health of children with benign epilepsy: a pilot study. Epilepsy & Behavior. 2014; (37): 151-156. https://doi.org/10.1016/j.yebeh.2014.06.017
- Gotze W., Kubicki S., Munter M., Teichmann J. Effect of physical exercise on seizure threshold (investigated by electroencephalographic telemetry). Diseases of the Nervous System. 1967; 28(10): 664-667.
- Horydn W., Gryziak J., Niedzielska K., Zielinski JJ. Effect of physical exertion on seizure discharges in the EEG of epilepsy patients. Neurologia i Neuro-chirurgia Polska. 1981; 15(5-6): 545-552.
- Collard S.S., Marlow C. The psychosocial impact of exercising with epilepsy: a narrative analysis. Epilepsy & Behavior. 2016; (61): 199-205. https://doi. org/10.1016/j.yebeh.2016.05.039
- Contant K.D., Morgan A.K., Muzykewicz D., Clark D.C., Thiele E.A. A karate program for improving self-concept and quality of life in childhood epilepsy: results of a pilot study. Epilepsy & Behavior. 2008; (12): 61-65. https://doi.org/10.1016/j.yebeh.2007.08.011
- Eom S., Lee M.K., Park J-H., Lee D., Kang H-C., Lee J.S., Jeon J.Y., Kim H.D. The impact of a 35-week long-term exercise therapy on psychosocial health of children with benign epilepsy. Journal of Child Neurology. 2016; (31): 985-990. https://doi.org/10.1177/0883073816634859
- Nyberg J., Aberg M.A.I., Toren K., Nilsson M., Ben-Menachem E., Kuhn H.G. Cardiovascular fitness and later risk of epilepsy: a Swedish population-based cohort study. Neurology. 2013; 81(12): 1051-1057. https://doi.org/10.1212/WNL.0b013e3182a4a4c0
- Ben-Menachem E. Weight issues for people with epilepsy—a review. Epilepsia. 2007; (48): 42-45. https://doi.org/10.1111/j.1528-1167.2007.01402.x
- Hellier J.L., Dudek F.E. Spontaneous motor seizures of rats with kainate-induced epilepsy: effect of time of day and activity state. Epilepsy Research. 1999; 35(1): 47-57. https://doi.org/10.1016/s0920-1211(98)00127-2
- Tutkun E., Ayyildiz M., Agar E. Short-duration swimming exercise decreases penicillin-induced epileptiform EcoG activity in rats. Acta Neurobiologiae Experimentalis. 2010; 70(4): 382-389
- Kayacan Y., Tutkun E., Arslan G., Ayyildiz M., Agar E. The effects of treadmill exercise on penicillin-induced epileptiform activity. Archives of Medical Science. 2016; 12(5): 935-940. https://doi.org/10.5114/aoms.2016.61907
- Radak Z., Chung H.Y., Goto S. Systemic adaptation to oxidative challenge induced by regular exercise. Free Radical Biology and Medicine. 2008; 44(2): 153-159. https://doi.org/10.1016/j.freeradbiomed.2007.01.029
- Nakken K.O., L0yning A., L0yning T., Gl0ersen G., Larsson P.G. Does physical exercise influence the occurrence of epileptiform EEG discharges in children? Epilepsia. 1997; 38(3): 279-284. https://doi.org/10.1111/j.1528-1157.1997.tb01118.x
- De Lima C., Vancini R.L., Arida R.M., Guilhoto L.M.F.F., de Mello M.T., Barreto A.T., Guaranha M.S.B., Yacubian E.M.T., Tufik S. Physiological and electroencephalographic responses to acute exhaustive physical exercise in people with juvenile myoclonic epilepsy. Epilepsy & Behavior. 2011; (22): 718-722. https://doi.org/10.1016/j.yebeh.2011.08.033
- Koirala G.R., Lee D., Eom S., Kim N-Y., Kim H.D. Altered brain functional connectivity induced by physical exercise may improve neuropsychological functions in patients with benign epilepsy. Epilepsy & Behavior. 2017; (76): 126-132. https://doi.org/10.1016/j.yebeh.2017.06.021
- Setkowicz Z., Mazur A. Physical training decreases susceptibility to subsequent pilocarpine-induced seizures in the rat. Epilepsy Research. 2006; 71(2-3): 142-148. https://doi.org/10.1016/j.eplepsyres.2006.06.002
- Arida R.M., Scorza F.A., dos Santos N.F., Peres C.A., Cavalheiro E.A. Effect of physical exercise on seizure occurrence in a model of temporal lobe epilepsy in rats. Epilepsy Research. 1999; 37(1): 45-52. https://doi.org/10.1016/S0920-1211(99)00032-7
- Contet C., Gaveriaux-Ruff C., Matifas A., Caradec C., Champy M-F., Kieffer B.L. Dissociation of analgesic and hormonal responses to forced swim stress using opioid receptor knockout mice. Neuropsychopharmacology. 2006; 31(8): 1733-1744. https://doi.org/10.1038/sj.npp.1300934
- Arida R.M., Scorza F.A., Toscano-Silva M., Cavalheiro E.A. Does exercise correct dysregulation of neurosteroid levels induced by epilepsy? Annals of Neurology. 2010; 68(6): 971-972. https://doi.org/10.1002/ana.22086
- Mevissen M., Ebert U. Anticonvulsant effects of melatonin in amygdala-kindled rats. Neuroscience Letters. 1998; 257(1): 13-16. https://doi.org/10.1016/ s0304-3940(98)00790-3
- Arida R.M., Scorza C.A., Scorza F.A., Gomes da Silva S., da Graga Naffah-Mazzacoratti M., Cavalheiro E.A. Effects of different types of physical exercise on the staining of parvalbumin-positive neurons in the hippocampal formation of rats with epilepsy. Progress in Neuro-Psychopharmacology and Biological Psychiatry. 2007; 31(4): 814-822. https://doi.org/10.1016/j.pnpbp.2007.01.021
- Arida R.M., Sanabria E.R.G., da Silva A.C., Faria L.C., Scorza F.A., Cavalheiro E.A. Physical training reverts hippocampal electrophysiological changes in rats submitted to the pilocarpine model of epilepsy. Physiology & Behavior. 2004; 83(1): 165-171. https://doi.org/10.1016/j.physbeh.2004.08.008
- Arida R.M., de Jesus Vieira A., Cavalheiro E.A. Effect of physical exercise on kindling development. Epilepsy Research. 1998; 30(2): 127-132. https://doi. org/10.1016/s0920-1211(97)00102-2
- Westergren T., Fegran L., Nilsen T., Haraldstad K., Kittang O.B., Berntsen S. Active play exercise intervention in children with asthma: a pilot study. BMJ Open. 2016; 6(1): e009721. https://doi.org/10.1136/bmjopen-2015-009721
- Yoneda Y., Kanmori K., Ida S., Kuriyama K. Stress-induced alterations in metabolism of gamma-aminobutyric acid in rat brain. Journal of Neurochemistry. 1983; 40(2): 350-356. https://doi.org/10.1111/j.1471-4159.1983.tb11289.x
- Souza M.A., Oliveira M.S., Furian A.F., Rambo L.M., Ribeiro L.R., Lima F.D., Dalla Corte L.C., Silva L.F.A., Retamoso L.T., Dalla Corte C.L., Puntel G.O., De Avila D.S., Soares F.A.A., Fighera M.R., De Mello C.F., Royes L.F.F. Swimming training prevents pentylenetetrazol-induced inhibition of Na+, K+-ATPase activity, seizures, and oxidative stress. Epilepsia. 2009; 50(4): 811-823. https://doi.org/10.1111/j.1528-1167.2008.01908.x
- Nistico G., Ciriolo M.R., Fiskin K., lannone M., de Martino A., Rotilio G. NGF restores decrease in catalase activity and increases superoxide dismutase and glutathione peroxidase activity in the brain of aged rats. Free Radical Biology and Medicine. 1992; 12(3): 177-181. https://doi.org/10.1016/0891-5849(92)90024-b
- Carro E., Trejo J.L., Busiguina S., Torres-Aleman I. Circulating insulin-like growth factor I mediates the protective effects of physical exercise against brain insults of different etiology and anatomy. The Journal of Neuroscience. 2001; 21(15): 5678-5684. https://doi.org/10.1523/JNEUROSCI.21-15-05678.2001
- Bj0rholt P.G., Nakken K.O., R0hme K., Hansen H. Leisure time habits and physical fitness in adults with epilepsy. Epilepsia. 1990; 31(1): 83-87. https://doi. org/10.1111/j.1528-1157.1990.tb05364.x
- Ogunyemi A.O., Gomez M.R., Klass D.W. Seizures induced by exercise. Neurology. 1988; 38(4): 633-6334. https://doi.org/10.1212/wnl.38.4.633
- Werz M.A. Idiopathic generalized tonic-clonic seizures limited to exercise in a young adult. Epilepsy & Behavior. 2005; 6(1): 98-101. https://doi. org/10.1016/j.yebeh.2004.11.008
- Eriksen H.R., Ellertsen B, Gronningsaeter H, Nakken K.O., L0yning Y., Ursin H. Physical exercise in women with intractable epilepsy. Epilepsia. 1994; (35): 1256-1264. https://doi.org/10.1111/j.1528-1157.1994.tb01797.x
- Simpson R.K.Jr., Grossman R.G. Seizures after jogging. The New England Journal of Medicine. 1989; 321(12): 835 p. https://doi.org/10.1056/ NEJM198909213211218
- Sturm J.W., Fedi M., Berkovic S.F., Reutens D.C. Exercise-induced temporal lobe epilepsy. Neurology. 2002; 59(8): 1246-1248. https://doi.org/10.1212/ wnl.59.8.1246
- Capovilla G., Kaufman K.R., Perucca E., Moshe S.L., Arida R.M. Epilepsy, seizures, physical exercise, and sports: a report from the ILAE Task Force on sports and epilepsy. Epilepsia. 2016; 57(1): 6-12. https://doi.org/10.1111/epi.13261
Контент доступен под лицензией Creative Commons Attribution 4.0 License.
©
Эта статья открытого доступа по лицензии CC BY 4.0. Издательство: ФГБУ «НМИЦ РК» Минздрава России.