title: Language disturbances as a side effect of prophylactic treatment of migraine.
abstract: BACKGROUND
  Language disturbances have been previously described as word-finding difficulties in epileptic patients. These disturbances have been recently reported in migraineurs in treatment with topiramate but they have never been defined and assessed in these patients with the aid of neuropsychological testing.
  
  
  OBJECTIVE
  To verify the occurrence of language disturbances as a side effect of topiramate treatment in episodic and chronic migraine patients.
  
  
  METHODS
  Language disturbances were recorded on the basis of spontaneous reports of 30 migraine patients treated with topiramate and 2 control groups (20 patients treated with other prophylactic drugs and 20 patients without prophylactic treatment) and were explored with neuropsychological tests. Psychiatric comorbidity was assessed using Zung Anxiety and Depression Scales.
  
  
  RESULTS
  Language disturbances were referred by 26.7% (n=8) of patients during topiramate treatment but by none of the patients in the 2 control groups. All patients in the topiramate group had a worse performance on all tests compared to patients of the 2 control groups. Moreover, in the topiramate group, patients with referred language disturbances had higher scores for all neuropsychological test variables, indicative of a worse performance. Some language functions (Trail Making Tests A and B) seemed to be influenced by the concomitant presence of psychiatric comorbidities, particularly anxiety and depression.
  
  
  CONCLUSIONS
  It can be hypothesized that a disorder such as migraine, which involves numerous cortical and subcortical circuits implicated in the transmission and behavioral and emotional processing of pain, represents a facilitated substrate for the occurrence of language disturbances due to topiramate. This could be the expression of a more generalized impairment of cognitive processing. These aspects should be investigated in prospective studies involving larger migraine patient samples.
authors.affiliation: Neurologic Clinic, Department of Medical and Surgical Specialties and Public Health, University of Perugia, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Coppola
authors.forename: Cristiana
authors.initials: C
authors.lastname: Rossi
authors.forename: Maria Luisa
authors.initials: ML
authors.lastname: Mancini
authors.forename: Ilenia
authors.initials: I
authors.lastname: Corbelli
authors.forename: Katiuscia
authors.initials: K
authors.lastname: Nardi
authors.forename: Paola
authors.initials: P
authors.lastname: Sarchielli
authors.forename: Paolo
authors.initials: P
authors.lastname: Calabresi
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D005260:Female; D005632:Fructose / Q000009:adverse effects / Q000031:analogs & derivatives*; D006801:Humans; D007806:Language Disorders / Q000139:chemically induced*; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000188:drug therapy*; D018696:Neuroprotective Agents / Q000009:adverse effects*; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D000077236:Topiramate
chemical_list: D018696:Neuroprotective Agents; D000077236:Topiramate; D005632:Fructose