LAUSR

The aim of this study was to understand the impact of human patterns of antiseizure drug (ASD) nonadherence on seizure control using a novel oral drug-delivery system in the kainate rat model of epilepsy. The main finding is that nonadherence to the ASD carbamazepine is associated with significant but reversible effects on seizure control, which shows that the model replicates clinical findings. As such, the study uses a reverse translational approach to validate the experimental paradigm chosen for these interesting series of experiments. As suggested by the authors, the experimental results demonstrate that animal studies of nonadherence can yield potentially important and translatable insights into the consequences of nonadherence on seizure control. An unexpected finding of the study was the lack of complete seizure control in most animals in the 100% perfect adherence group, indicating that the chronic epilepsy model used closely replicates mesial temporal lobe epilepsy with a high level of drug resistance. In addition to the experimental design of this first-of-a-kind pilot study, I was particularly impressed by the computer-controlled automated delivery system that provides tight control over chronic oral medication dosing in rats. In this respect, it is highly advantageous compared to conventional drug administration via the food or drinking water in rodents, which is associated with large circadian variation in drug intake. The innovative open-source drug-delivery system has been previously described in detail by Kyle Thomson and Steve White to allow its use by other investigators, which is to be saluted.