Intracerebroventricular administration for delivery of antiseizure therapeutics: Challenges and opportunities

Abstract

Approximately 30% of patients with epilepsy do not respond to pharmacological treatment. In these patients, epilepsy is associated with poor quality of life and an increased risk of morbidity and mortality. 1 Drug resistance has been attributed to pathological processes that can affect both pharmacokinetics and pharmacodynamics (e.g., inflammation). 2 Among the pharmacokinetic contributors is reduced drug distribution to epileptogenic brain tissue across the blood-brain barrier (BBB), 3 which has been associated with locally altered expression of drug transporters and

Photopharmacological activation of adenosine A1receptor signaling suppresses seizures in a mouse model for temporal lobe epilepsy

“…Compounds were injected into the lateral ventricle contralateral to the site of EP/EEG recording and illumination. This route of administration is a relatively effective way to ensure delivery of compounds to the brain, especially in periventricular regions such as the hippocampus 52 . However, the actual concentration of cCPA that reaches the hippocampus and that would be available for uncaging is unknown.…”

An Overview on the Physiopathology of the Blood–Brain Barrier and the Lipid-Based Nanocarriers for Central Nervous System Delivery

“…The pump is the most used since it guarantees a more continuous and elevated concentration of drug in the CSF. This method of administration allows a reduction in systemic side effects and avoids drug metabolism in blood serum and opsonization [49]. However, ICV administration has some significant drawbacks and risks.…”