Interventions with neuroprotective agents: Novel targets and opportunities

Several antiepileptic drugs have demonstrated neuroprotective properties in animal models by inhibiting the components of the excitotoxic cascade. The process of neurodegeneration appears to be dependent on the mitochondria, with their central role as regulators of both energy metabolism and apoptotic pathways during seizures. Excess cytosolic Ca²⁺ during periods of excitotoxicity disrupts homeostasis in the mitochondria, causing inhibition of adenosine triphosphate synthesis and increased production of reactive oxygen species, with resultant oxidative damage, leading to neuronal cell death. The Ca²⁺-mediated mitochondrial dysfunction in epilepsy may be the main target for neuroprotective intervention by antiepileptic drugs.