Xiao, Fenglai;
Caciagli, Lorenzo;
Wandschneider, Britta;
Fleury, Marine;
Binding, Lawrence;
Giampiccolo, Davide;
Hill, Andrea;
... Koepp, Matthias J; + view all
(2023)
Verbal fluency functional magnetic resonance imaging detects anti-seizure effects and affective side effects of perampanel in people with focal epilepsy.
Epilepsia
, 64
(2)
e9-e15.
10.1111/epi.17493.
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Duncan_Epilepsia - 2022 - Xiao - Verbal fluency functional magnetic resonance imaging detects anti‐seizure effects and affective.pdf Download (1MB) | Preview |
Abstract
Perampanel, a non-competitive antagonist of the post-synaptic a-amino-3-hydroxy-5-methyl-4-isoxazolepropionic (AMPA) receptor, is effective for controlling focal to bilateral tonic-clonic seizures but also known to increase feelings of anger. Using statistical parametric mapping-derived measures of activation and task-modulated functional connectivity (psychophysiologic interaction), we investigated 14 people with focal epilepsy who had verbal fluency fMRI twice, before and after the add-on treatment of perampanel. For comparison, we included 28 people with epilepsy, propensity-matched for clinical characteristics, who had two scans but no change in ASM regime in-between. After commencing perampanel, individuals had higher task-related activations in left orbito-frontal cortex (OFC), less task-related activations in subcortical regions including left thalamus and left caudate, and lower task-related thalamo-caudate and caudate-subtantial nigra connectivity. Decreased task-related connectivity is observed between left OFC and precuneus and left medial frontal lobe. Our results highlight the brain regions associated with the beneficiary therapeutic effects on focal to bilateral tonic-clonic seizures (thalamus and caudate) but also the undesired affective side effects of perampanel with increased anger and aggression (OFC).
| Type: | Article |
|---|---|
| Title: | Verbal fluency functional magnetic resonance imaging detects anti-seizure effects and affective side effects of perampanel in people with focal epilepsy |
| Location: | United States |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1111/epi.17493 |
| Publisher version: | https://doi.org/10.1111/epi.17493 |
| Language: | English |
| Additional information: | © 2022 The Authors. Epilepsia published by Wiley Periodicals LLC on behalf of International League Against Epilepsy. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
| Keywords: | Anti-seizure medication, fMRI, focal epilepsy, longitudinal, perampanel, undesired effects |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Clinical and Experimental Epilepsy |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10162055 |
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