Copyright
©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
Chronic antiepileptic drug use and functional network efficiency: A functional magnetic resonance imaging study
Tamar M van Veenendaal, Dominique M IJff, Albert P Aldenkamp, Richard H C Lazeron, Paul A M Hofman, Anton J A de Louw, Walter H Backes, Jacobus F A Jansen
Tamar M van Veenendaal, Dominique M IJff, Albert P Aldenkamp, Paul A M Hofman, Walter H Backes, Jacobus FA Jansen, School for Mental Health and Neuroscience, Maastricht University, 6200 MD, Maastricht, The Netherlands
Tamar M van Veenendaal, Paul A M Hofman, Walter H Backes, Jacobus F A Jansen, Departments of Radiology and Nuclear Medicine, Maastricht University Medical Center, 6202 AZ, Maastricht, The Netherlands
Dominique M IJff, Albert P Aldenkamp, Richard H C Lazeron, Paul A M Hofman, Anton J A de Louw, Departments of Neurology and Neuropsychology, Epilepsy Center Kempenhaeghe, 5590 AB, Heeze, The Netherlands
Albert P Aldenkamp, Department of Neurology, Gent University Hospital, 9000 Gent, Belgium
Albert P Aldenkamp, Anton J A de Louw, Department of Neurology, Maastricht University Medical Center, 6202 AZ, Maastricht, The Netherlands
Albert P Aldenkamp, Anton J A de Louw, Faculty of Electrical Engineering, University of Technology Eindhoven, 5600 MB, Eindhoven, The Netherlands
Author contributions: Aldenkamp AP, Lazeron RHC, Backes WH and Jansen JFA designed to research; IJff DM and Lazeron RHC included patients; van Veenendaal TM and IJff DM performed the research; van Veenendaal TM, IJff DM, Hofman PAM, de Louw AJA, Backes WH and Jansen JFA analyzed the data; van Veenendaal TM, Backes WH and Jansen JFA wrote the paper.
Institutional review board statement: This observational study was reviewed and approved by the Medical Ethical Committee of Maastricht University Medical Center.
Informed consent statement: All study participants provided written informed consent prior to study enrollment.
Conflict-of-interest statement: There are no conflicts of interest to disclose for this study.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Jacobus F A Jansen, PhD, Departments of Radiology and Nuclear Medicine, Maastricht University Medical Center, PO Box 5800, 6202 AZ, Maastricht, The Netherlands. jacobus.jansen@mumc.nl
Telephone: +31-043-3874908 Fax: +31-043-3876909
Received: October 15, 2016
Peer-review started: October 19, 2016
First decision: January 16, 2017
Revised: February 24, 2017
Accepted: March 23, 2017
Article in press: March 24, 2017
Published online: June 28, 2017
AIM
To increase our insight in the neuronal mechanisms underlying cognitive side-effects of antiepileptic drug (AED) treatment.
METHODS
The relation between functional magnetic resonance-acquired brain network measures, AED use, and cognitive function was investigated. Three groups of patients with epilepsy with a different risk profile for developing cognitive side effects were included: A “low risk” category (lamotrigine or levetiracetam, n = 16), an “intermediate risk” category (carbamazepine, oxcarbazepine, phenytoin, or valproate, n = 34) and a “high risk” category (topiramate, n = 5). Brain connectivity was assessed using resting state functional magnetic resonance imaging and graph theoretical network analysis. The Computerized Visual Searching Task was used to measure central information processing speed, a common cognitive side effect of AED treatment.
RESULTS
Central information processing speed was lower in patients taking AEDs from the intermediate and high risk categories, compared with patients from the low risk category. The effect of risk category on global efficiency was significant (P < 0.05, ANCOVA), with a significantly higher global efficiency for patient from the low category compared with the high risk category (P < 0.05, post-hoc test). Risk category had no significant effect on the clustering coefficient (ANCOVA, P > 0.2). Also no significant associations between information processing speed and global efficiency or the clustering coefficient (linear regression analysis, P > 0.15) were observed.
CONCLUSION
Only the four patients taking topiramate show aberrant network measures, suggesting that alterations in functional brain network organization may be only subtle and measureable in patients with more severe cognitive side effects.
Core tip: Slowed information processing is a commonly observed cognitive side-effect of antiepileptic drug (AED) treatment. We aimed to increase our insight in the neuronal mechanisms underlying this side-effect. Therefore, the relation between functional MR-acquired brain network measures, AED use, and cognitive function was investigated. No associations were found between information processing speed and graph measures, and only the four patients taking topiramate (with a high risk on cognitive side effects) showed aberrant network measures. The results suggest that alterations in functional brain network organization may be only subtle and measureable in patients with more severe cognitive side effects.
