Abstract #0312

Backes W, Majoie H, Hofman P, de Krom M, Nicolay K, Kooi M, Aldenkamp A, Jansen J, Reijs R

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.