Carbamazepine reduces memory induced activation of mesial temporal lobe structures: a pharmacological fMRI-study
Tóm tắt
It is not known whether carbamazepine (CBZ; a drug widely used in neurology and psychiatry) influences the blood oxygenation level dependent (BOLD) contrast changes induced by neuronal activation and measured by functional MRI (fMRI). We aimed to investigate the influence of CBZ on memory induced activation of the mesial temporal lobes in patients with symptomatic temporal lobe epilepsy (TLE). Twenty-one individual patients with refractory symptomatic TLE with different CBZ serum levels and 20 healthy controls were studied using BOLD fMRI. Mesial temporal lobe (MTL) activation was induced by a task that is based on the retrieval of individually familiar visuo-spatial knowledge. The extent of significant MTL fMRI activation was measured and correlated with the CBZ serum level. In TLE patients, the extent of significant fMRI activation over both MTL was negatively correlated to the CBZ serum level (Spearman r = -0.654, P < 0.001). Activation over the supposedly normal MTL, i.e. contralateral to the seizure onset of TLE patients, was smaller than the averaged MTL activation in healthy controls (P < 0.005). Age, duration of epilepsy, side of seizure onset, and intelligence were not correlated to the extent of the significant BOLD-response over both MTL in patients with TLE. In TLE patients, carbamazepine reduces the fMRI-detectable changes within the mesial temporal lobes as induced by effortful memory retrieval. FMRI appears to be suitable to study the effects of chronic drug treatment in patients with epilepsy.
Tài liệu tham khảo
Springer JA, Binder JR, Hammeke TA, et al: Language dominance in neurologically normal and epilepsy subjects. Brain. 1999, 122: 2033-2045. 10.1093/brain/122.11.2033.
Detre JA, Maccotta L, King D, et al: Functional MRI lateralization of memory in temporal lobe epilepsy. Neurology. 1998, 50: 926-32.
May A, Bahra A, Büchel C, Turner R, Goadsby PJ: Functional magnetic resonance imaging in spontaneous attacks of SUNCT: short-lasting neuralgiform headache with conjunctival injection and tearing. Ann Neurol. 1999, 46: 791-794. 10.1002/1531-8249(199911)46:5<791::AID-ANA18>3.0.CO;2-8.
Stoll AL, Renshaw PF, Yurgelun-Todd DA, Cohen BM: Neuroimaging in bipolar disorder: what have we learned?. Biol Psychiatry. 2000, 48: 505-517. 10.1016/S0006-3223(00)00982-3.
Mattson RH, Cramer JA, Collins JF, et al: A comparison of valproate and carbamazepine for the treatment of complex partial seizures and secondarily generalized tonic-clonic seizures in adults. N Engl J Med. 1992, 327: 765-771.
Post RM, Altshuler LL, Ketter TA, et al: Antiepileptic drugs in affective illness – clinical and theoretical implications. Adv Neurol. 1991, 55: 239-277.
Ross EL: The evolving role of antiepileptic drugs in treating neuropathic pain. Neurology. 2000, 55(suppl.1): S54-S58.
Theodore WH: Antiepileptic drugs and cerebral glucose metabolism. Epilepsia. 1988, 29(suppl.2): S48-S55.
Jokeit H, Okujava M, Woermann FG: Memory fMRI lateralizes temporal lobe epilepsy. Neurology. 2001, 57: 1786-1792.
Roland PE, Eriksson L, Stone-Elander S, Widen L: Does mental activity change the oxidative metabolism of the brain?. J Neurosci. 1987, 7: 2373-2389.
Greiff A, Fernandez G, Oertzen J, et al: Language mapping using real-time functional MRI: an evaluation study. Epilepsia. 2000, 41(Suppl.): 56-
Leslie RA, James MF: Pharmacological magnetic resonance imaging: a new application for functional MRI. Trends Pharmacol Sci. 2000, 21: 314-318. 10.1016/S0165-6147(00)01507-8.
Sauter A, Rudin M: Pharmacological MRI: a nebulous concept. Trends Pharmacol Sci. 2000, 21: 422-423. 10.1016/S0165-6147(00)01557-1.
Bellgowan PSF, Binder JR, Swanson SJ, et al: Side of seizure focus predicts left medial temporal lobe activation during verbal coding. Neurology. 1998, 51: 479-484.
Dupont S, Van de Moortele PF, Samson S: Episodic memory in left temporal lobe epilepsy: a functional MRI study. Brain. 2000, 123: 1722-1732. 10.1093/brain/123.8.1722.
Krakow K, Woermann FG, Symms MR, et al: EEG-triggered functional MRI of interictal epileptiform activity in patients with partial seizures. Brain. 1999, 122: 1679-1688. 10.1093/brain/122.9.1679.
Bruhn H, Kleinschmidt A, Boecker H, Merboldt KD, Hänicke W, Frahm J: The effect of acetazolamide on regional cerebral blood oxygenation at rest and under stimulation as assessed by MRI. J Cereb Blood Flow Metab. 1994, 14: 742-748.
Breiter HC, Gollub RL, Weisskoff RM, et al: Acute effects of cocaine on human brain activity and emotion. Neuron. 1997, 19: 591-611.
Stein EA, Pankiewicz J, Harsch HH, et al: Nicotine-induced alterations of brain activities in humans: a functional MRI study. American J Psychiatry. 1998, 155: 1009-1015.
Kleinschmidt A, Bruhn A, Krüger G, et al: Effects of sedation, stimulation, placebo on cerebral blood oxygenation: a magnetic resonance neuroimaging study of psychotropic drug action. NMR Biomed. 1999, 12: 286-292. 10.1002/(SICI)1099-1492(199908)12:5<286::AID-NBM576>3.0.CO;2-Q.
Kalin NH, Davidson RJ, Irwin R, et al: Functional magnetic resonance imaging studies of emotional processing in normal and depressed patients: effects of venlafaxine. J Clin Psychiatry. 1997, 58(suppl.16): 32-39.
Maguire EA, Frith CD, Burgess N, et al: Knowing where things are – parahippocampal involvement in encoding object locations in virtual large-scale space. Cogn Neurosci. 1998, 10: 61-76. 10.1162/089892998563789.
Grady CL, Mclntosh AR, Rajah MN, Craik FI: Neural correlates of the episodic encoding of pictures and words. Proc Natl Acad Sci USA. 1998, 95: 2703-2708. 10.1073/pnas.95.5.2703.
Thompson PJ, Trimble MR: Anticonvulsant serum levels: relationship to impairments of cognitive functioning. J Neurol Neurosurg Psychiatry. 1983, 46: 227-233.
Malonek D, Grinvald A: Interactions between electrical activity and cortical microcirculation revealed by imaging spectroscopy: implications for functional brain mapping. Science. 1996, 272: 551-554.
Cabeza R, Nyberg L: Imaging cognition II: An empirical review of 275 PET and fMRI studies. J Cogn Neurosci. 2000, 12: 1-47. 10.1162/08989290051137585.
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