Metabolic and functional MR biomarkers of antiepileptic drug effectiveness: A review. (December 2015)

• Record Type: Journal Article
• Authors: van Veenendaal, Tamar M.; IJff, Dominique M.; Aldenkamp, Albert P.; Hofman, Paul A.M.; Vlooswijk, Marielle C.G.; Rouhl, Rob P.W.; de Louw, Anton J.; Backes, Walter H.; Jansen, Jacobus F.A.
• Is Part Of: Neuroscience and biobehavioral reviews. Volume 59(2015:Dec.)
• Page Start: 92
• Page End: 99
• Publication Date: 2015-12
• Subjects: Cognitive side effects -- Treatment failure -- Anticonvulsant -- MR spectroscopy -- Functional MRI; Psychophysiology -- Periodicals; Human behavior -- Periodicals; Animal behavior -- Periodicals; Neurology -- Periodicals; Behavior -- Periodicals; Ethology -- Periodicals; Neurology -- Periodicals; Psychophysiologie -- Périodiques; Comportement humain -- Périodiques; Animaux -- Mœurs et comportement -- Périodiques; Neurologie -- Périodiques; Animal behavior; Human behavior; Neurology; Psychophysiology; Periodicals; Electronic journals; 573.8
• DOI: 10.1016/j.neubiorev.2015.10.004
• Languages: English
• ISSNs: 0149-7634

Abstract

Highlights: Distinct GABAergic AEDs have been shown to increase the GABA concentration. AED induced increases in GABA concentration were associated with seizure control. Cognitive side effects can be associated with altered brain activation patterns. MR spectroscopy and fMRI might provide biomarkers to predict treatment outcomes. Abstract: As a large number of patients with epilepsy do not respond favorably to antiepileptic drugs (AEDs), a better understanding of treatment failure and the cause of adverse side effects is required. The working mechanisms of AEDs also alter neurotransmitter concentrations and brain activity, which can be measured using MR spectroscopy and functional MR imaging, respectively. This review presents an overview of clinical research of MR spectroscopy and functional MR imaging studies to the effects of AEDs on the brain. Despite the scarcity of studies associating MR findings to the effectiveness of AEDs, the current research shows clear potential regarding this matter. Several GABAergic AEDs have been shown to increase the GABA concentration, which was related to seizure reductions, while language problems due to topiramate have been associated with altered activation patterns measured with functional MR imaging. MR spectroscopy and functional MR imaging provide biomarkers that may predict individual treatment outcomes, and enable the assessment of mechanisms of treatment failure and cognitive side effects.