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Published in: BMC Neurology 1/2001

Open Access 01-12-2001 | Research article

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

Authors: Hennric Jokeit, Michael Okujava, Friedrich G Woermann

Published in: BMC Neurology | Issue 1/2001

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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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Literature
1.
go back to reference 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.CrossRefPubMed 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.CrossRefPubMed
2.
go back to reference Detre JA, Maccotta L, King D, et al: Functional MRI lateralization of memory in temporal lobe epilepsy. Neurology. 1998, 50: 926-32.CrossRefPubMed Detre JA, Maccotta L, King D, et al: Functional MRI lateralization of memory in temporal lobe epilepsy. Neurology. 1998, 50: 926-32.CrossRefPubMed
3.
go back to reference 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.CrossRefPubMed 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.CrossRefPubMed
4.
go back to reference 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.CrossRefPubMed 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.CrossRefPubMed
5.
go back to reference 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.CrossRefPubMed 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.CrossRefPubMed
6.
go back to reference Post RM, Altshuler LL, Ketter TA, et al: Antiepileptic drugs in affective illness – clinical and theoretical implications. Adv Neurol. 1991, 55: 239-277.PubMed Post RM, Altshuler LL, Ketter TA, et al: Antiepileptic drugs in affective illness – clinical and theoretical implications. Adv Neurol. 1991, 55: 239-277.PubMed
7.
go back to reference Ross EL: The evolving role of antiepileptic drugs in treating neuropathic pain. Neurology. 2000, 55(suppl.1): S54-S58. Ross EL: The evolving role of antiepileptic drugs in treating neuropathic pain. Neurology. 2000, 55(suppl.1): S54-S58.
8.
go back to reference Theodore WH: Antiepileptic drugs and cerebral glucose metabolism. Epilepsia. 1988, 29(suppl.2): S48-S55.CrossRef Theodore WH: Antiepileptic drugs and cerebral glucose metabolism. Epilepsia. 1988, 29(suppl.2): S48-S55.CrossRef
9.
go back to reference Jokeit H, Okujava M, Woermann FG: Memory fMRI lateralizes temporal lobe epilepsy. Neurology. 2001, 57: 1786-1792.CrossRefPubMed Jokeit H, Okujava M, Woermann FG: Memory fMRI lateralizes temporal lobe epilepsy. Neurology. 2001, 57: 1786-1792.CrossRefPubMed
10.
go back to reference 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.PubMed 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.PubMed
11.
go back to reference Greiff A, Fernandez G, Oertzen J, et al: Language mapping using real-time functional MRI: an evaluation study. Epilepsia. 2000, 41(Suppl.): 56- Greiff A, Fernandez G, Oertzen J, et al: Language mapping using real-time functional MRI: an evaluation study. Epilepsia. 2000, 41(Suppl.): 56-
12.
go back to reference 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.CrossRefPubMed 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.CrossRefPubMed
13.
go back to reference Sauter A, Rudin M: Pharmacological MRI: a nebulous concept. Trends Pharmacol Sci. 2000, 21: 422-423. 10.1016/S0165-6147(00)01557-1.CrossRefPubMed Sauter A, Rudin M: Pharmacological MRI: a nebulous concept. Trends Pharmacol Sci. 2000, 21: 422-423. 10.1016/S0165-6147(00)01557-1.CrossRefPubMed
14.
go back to reference 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.CrossRefPubMed 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.CrossRefPubMed
15.
go back to reference 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.CrossRefPubMed 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.CrossRefPubMed
16.
go back to reference 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.CrossRefPubMed 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.CrossRefPubMed
17.
go back to reference 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.CrossRefPubMed 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.CrossRefPubMed
18.
go back to reference Breiter HC, Gollub RL, Weisskoff RM, et al: Acute effects of cocaine on human brain activity and emotion. Neuron. 1997, 19: 591-611.CrossRefPubMed Breiter HC, Gollub RL, Weisskoff RM, et al: Acute effects of cocaine on human brain activity and emotion. Neuron. 1997, 19: 591-611.CrossRefPubMed
19.
go back to reference 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.CrossRef 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.CrossRef
20.
go back to reference 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.CrossRefPubMed 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.CrossRefPubMed
21.
go back to reference 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. 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.
22.
go back to reference 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.CrossRef 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.CrossRef
23.
go back to reference 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.CrossRefPubMedPubMedCentral 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.CrossRefPubMedPubMedCentral
24.
go back to reference Thompson PJ, Trimble MR: Anticonvulsant serum levels: relationship to impairments of cognitive functioning. J Neurol Neurosurg Psychiatry. 1983, 46: 227-233.CrossRefPubMedPubMedCentral Thompson PJ, Trimble MR: Anticonvulsant serum levels: relationship to impairments of cognitive functioning. J Neurol Neurosurg Psychiatry. 1983, 46: 227-233.CrossRefPubMedPubMedCentral
25.
go back to reference 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.CrossRefPubMed 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.CrossRefPubMed
26.
go back to reference 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.CrossRefPubMed 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.CrossRefPubMed
Metadata
Title
Carbamazepine reduces memory induced activation of mesial temporal lobe structures: a pharmacological fMRI-study
Authors
Hennric Jokeit
Michael Okujava
Friedrich G Woermann
Publication date
01-12-2001
Publisher
BioMed Central
Published in
BMC Neurology / Issue 1/2001
Electronic ISSN: 1471-2377
DOI
https://doi.org/10.1186/1471-2377-1-6

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