The effect of topiramate on cognitive fMRI
Autor: | Mark R. Symms, Christian Vollmar, Fernando Cendes, Pamela J. Thompson, Maria Centeno, John S. Duncan, Mitul A. Mehta, Jason Stretton, Matthias J. Koepp, Clarissa L. Yasuda |
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Jazyk: | angličtina |
Předmět: |
Topiramate
Adult Male medicine.medical_specialty Short Communication Clinical Neurology Pilot Projects Fructose Audiology behavioral disciplines and activities 03 medical and health sciences Epilepsy Young Adult 0302 clinical medicine Cognition medicine Verbal fluency test Humans Longitudinal Studies Default mode network 030304 developmental biology Language 0303 health sciences medicine.diagnostic_test Neuropsychology Middle Aged medicine.disease Magnetic Resonance Imaging 3. Good health Cross-Sectional Studies Treatment Outcome Neurology Frontal lobe Anticonvulsants Female Neurology (clinical) Epilepsies Partial Psychology Functional magnetic resonance imaging Neuroscience 030217 neurology & neurosurgery medicine.drug |
Zdroj: | Epilepsy Research |
ISSN: | 0920-1211 |
DOI: | 10.1016/j.eplepsyres.2012.12.007 |
Popis: | Summary Purpose Topiramate (TPM) is known to cause language impairment in healthy volunteers and patients with epilepsy. We assessed the effects of TPM on functional language networks in both patients with focal epilepsies and healthy controls using functional magnetic resonance imaging (fMRI). Methods We obtained fMRI data in 24 controls and 35 patients with frontal lobe epilepsy using a simple verbal fluency (VF) paradigm. Eight of the 35 patients were treated with TPM in polytherapy. We compared cognitive task related activations and de-activations in patients taking TPM with patients taking other AEDs and healthy controls. In a longitudinal pilot study with VF-fMRI paradigm, we studied two patients with focal epilepsies twice, prior to starting and on stable doses of TPM, two patients twice, before and after tapering TPM completely and two healthy controls twice, before and after single doses of 200 mg TPM. Key findings Cross sectional analyses of VF-fMRI showed a reduction in the task-related deactivation of the default mode network (DMN) in patients taking TPM. The longitudinal study corroborated these findings as both chronic administration and a single dose of TPM were associated with impaired categorical verbal fluency and disruption of task-related deactivations. Significance Similar neuropsychological and fMRI findings in patients and healthy controls indicate a specific effect of TPM in default mode network areas that may be essential components of the language network. Our preliminary data suggest a mechanism by which TPM impairs cognitive processing during language function and highlights the sensitivity of fMRI to detect the effects of AEDs on cognitive brain networks. |
Databáze: | OpenAIRE |
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