The Effect of Topiramate and Lamotrigine on Cerebral Glucose Metabolism in Idiopathic Generalized Epilepsy Patients.
- Author:
Eun Yeon JOO
1
;
Woo Suk TAE
;
Sun Jung HAN
;
Suk Keun HAN
;
Sung Ik LEE
;
Dae Won SEO
;
Kyung Han LEE
;
Seung Bong HONG
Author Information
1. Department of Neurology, Samsung Medical Center and Center for Clinical Medicine, SBRI, Sungkyunkwan University School of Medicine, Seoul, Korea. sbhong@smc.samsung.co.kr
- Publication Type:Original Article
- Keywords:
Epilepsy;
Topiramate;
Lamotrigine;
Cerebral metabolism;
FDG-PET;
Statistical parametric mapping
- MeSH:
Anticonvulsants;
Brain;
Corpus Callosum;
Diagnosis;
Epilepsy;
Epilepsy, Generalized*;
Glucose*;
Humans;
Immunoglobulin E;
Metabolism*;
Positron-Emission Tomography;
Seizures;
Thalamus
- From:Journal of Korean Epilepsy Society
2005;9(2):129-136
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: To investigate the effects of topiramate (TPM) or lamotrigine (LTG) on cerebral glucose metabolism, we performed 18F-fluorodeoxy glucose positron emission tomography (FDG-PET) before and after medication in patients with drug naive idiopathic generalized epilepsy. METHODS: Thiry-three patients with newly diagnosed as idiopathic generalized epilepsy (IGE) or IGE without antiepileptic drugs after diagnosis were included. Pre- and post-antiepileptic drug FDG-PET were performed (before and after TPM or LTG administration) in 33 subjects treated with TPM or LTG who had been seizure free for at least 8 weeks. Sixteen of patients received TPM (M/F=8/8, aged 29.2+/-12.3 years) and 17 LTG (M/F=8/9, 26.8+/-9.3 years). For statistical paramateric (SPM) analysis, all PET images were spatially normalized to the standard PET template and then smoothed using a 12-mm full width at half-maximum Gaussian kernel. The paired t-test was used to compare pre- and post-medication FDG-PET images. RESULTS: SPM analysis of post- and pre-medication FDG-PETs showed TPM reduced glucose metabolism markedly in the thalamus, corpus callosum, and white matters, whereas LTG decreased glucose metabolism in cortico-striato-entorhinal areas with a false discovery rate corrected p<0.05. No brain region showed post-medication hypermetabolism in either group. CONCLUSION: Our study demonstrates that both TPM and LTG affect the cerebral glucose metabolism in drug naive idiopathic generalized epilepsy patients.
