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Clinical Trial
. 2001 Dec 18:1:6.
doi: 10.1186/1471-2377-1-6. Epub 2001 Dec 18.

Carbamazepine reduces memory induced activation of mesial temporal lobe structures: a pharmacological fMRI-study

H Jokeit  1 , M Okujava, F G Woermann
Affiliations
Clinical Trial

Carbamazepine reduces memory induced activation of mesial temporal lobe structures: a pharmacological fMRI-study

H Jokeit et al. BMC Neurol. .

Abstract

Background and purpose: 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).

Material and methods: 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.

Results: 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.

Conclusions: 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.

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Figures

Figure 1
Figure 1
Representative example of functional images of a 31-year-old female patient with left sided hippocampal sclerosis. Those voxels whose signal intensity significantly increased (z > 4) in association with the visuo-spatial memory retrieval task are displayed in white. Four consecutive slices of significant voxels superimposed on EPI images are shown. The right, contralateral MTL region shows more significantly activated voxels than the left diseased MTL.
Figure 2
Figure 2
Scatterplot of the number of activated voxels (contralateral to seizure onset in patients with TLE) as a function of the CBZ serum level. Five patients receiving GBP and LTG as add-on therapy are indicated. The linear regression function is shown. The gray line represents the median number of activated MTL voxels (half of total number) of 20 healthy controls. Only four patients had more activated voxels than the median of controls.
See this image and copyright information in PMC

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