fMRI reveals declined activation of prefrontal cortex in epilepsy patients on topiramate therapy
Backes W, Majoie H, Hofman P, de Krom M, Nicolay K, Kooi M, Aldenkamp A, Jansen J, Reijs R
University Hospital Maastricht, Eindhoven University of Technology
The antiepileptic drug topiramate is often associated with cognitive side effects. We used fMRI of covert word generation to examine brain activation abnormalities associated with topiramate-induced cognitive impairment in patients with epilepsy. Compared with a control epilepsy group, the topiramate group showed significantly less activation in the language-mediating cortical regions (left inferior prefrontal cortex (IPC) and the medial prefrontal cortex (MPC)) together with significant lower neuropsychological language scores. Furthermore, the IPC and MPC display a higher relative sensitivity to TPM treatment than other brain regions.These findings suggest that topiramate has a critical effect on the cerebral neural systems that mediate expressive language.