title: Metabolic and functional MR biomarkers of antiepileptic drug effectiveness: A review.
abstract: As a large number of patients with epilepsy do not respond favorably to antiepileptic drugs (AEDs), a better understanding of treatment failure and the cause of adverse side effects is required. The working mechanisms of AEDs also alter neurotransmitter concentrations and brain activity, which can be measured using MR spectroscopy and functional MR imaging, respectively. This review presents an overview of clinical research of MR spectroscopy and functional MR imaging studies to the effects of AEDs on the brain. Despite the scarcity of studies associating MR findings to the effectiveness of AEDs, the current research shows clear potential regarding this matter. Several GABAergic AEDs have been shown to increase the GABA concentration, which was related to seizure reductions, while language problems due to topiramate have been associated with altered activation patterns measured with functional MR imaging. MR spectroscopy and functional MR imaging provide biomarkers that may predict individual treatment outcomes, and enable the assessment of mechanisms of treatment failure and cognitive side effects.
authors.affiliation: Departments of Radiology and Nuclear Medicine, Maastricht University Medical Center, PO Box 5800, 6202 AZ Maastricht, The Netherlands; School for Mental Health and Neuroscience, Maastricht University, PO Box 616, 6200 MD Maastricht, The Netherlands.
authors.forename: Tamar M
authors.initials: TM
authors.lastname: van Veenendaal
authors.affiliation: School for Mental Health and Neuroscience, Maastricht University, PO Box 616, 6200 MD Maastricht, The Netherlands; Epilepsy Center Kempenhaeghe, PO Box 61, 5590 AB Heeze, The Netherlands.
authors.forename: Dominique M
authors.initials: DM
authors.lastname: IJff
authors.affiliation: School for Mental Health and Neuroscience, Maastricht University, PO Box 616, 6200 MD Maastricht, The Netherlands; Epilepsy Center Kempenhaeghe, PO Box 61, 5590 AB Heeze, The Netherlands; Department of Neurology, Maastricht University Medical Center, PO Box 5800, 6202 AZ Maastricht, The Netherlands; Department of Neurology, Gent University Hospital, De Pintelaan 185, 9000 Gent, Belgium; Faculty of Electrical Engineering, University of Technology Eindhoven, PO Box 513, 5600 MB Eindhoven, The Netherlands.
authors.forename: Albert P
authors.initials: AP
authors.lastname: Aldenkamp
authors.affiliation: Departments of Radiology and Nuclear Medicine, Maastricht University Medical Center, PO Box 5800, 6202 AZ Maastricht, The Netherlands; School for Mental Health and Neuroscience, Maastricht University, PO Box 616, 6200 MD Maastricht, The Netherlands; Epilepsy Center Kempenhaeghe, PO Box 61, 5590 AB Heeze, The Netherlands.
authors.forename: Paul A M
authors.initials: PA
authors.lastname: Hofman
authors.affiliation: School for Mental Health and Neuroscience, Maastricht University, PO Box 616, 6200 MD Maastricht, The Netherlands; Epilepsy Center Kempenhaeghe, PO Box 61, 5590 AB Heeze, The Netherlands; Department of Neurology, Maastricht University Medical Center, PO Box 5800, 6202 AZ Maastricht, The Netherlands.
authors.forename: Marielle C G
authors.initials: MC
authors.lastname: Vlooswijk
authors.affiliation: School for Mental Health and Neuroscience, Maastricht University, PO Box 616, 6200 MD Maastricht, The Netherlands; Epilepsy Center Kempenhaeghe, PO Box 61, 5590 AB Heeze, The Netherlands; Department of Neurology, Maastricht University Medical Center, PO Box 5800, 6202 AZ Maastricht, The Netherlands.
authors.forename: Rob P W
authors.initials: RP
authors.lastname: Rouhl
authors.affiliation: Epilepsy Center Kempenhaeghe, PO Box 61, 5590 AB Heeze, The Netherlands; Department of Neurology, Maastricht University Medical Center, PO Box 5800, 6202 AZ Maastricht, The Netherlands; Faculty of Electrical Engineering, University of Technology Eindhoven, PO Box 513, 5600 MB Eindhoven, The Netherlands.
authors.forename: Anton J
authors.initials: AJ
authors.lastname: de Louw
authors.affiliation: Departments of Radiology and Nuclear Medicine, Maastricht University Medical Center, PO Box 5800, 6202 AZ Maastricht, The Netherlands; School for Mental Health and Neuroscience, Maastricht University, PO Box 616, 6200 MD Maastricht, The Netherlands.
authors.forename: Walter H
authors.initials: WH
authors.lastname: Backes
authors.affiliation: Departments of Radiology and Nuclear Medicine, Maastricht University Medical Center, PO Box 5800, 6202 AZ Maastricht, The Netherlands; School for Mental Health and Neuroscience, Maastricht University, PO Box 616, 6200 MD Maastricht, The Netherlands. Electronic address: jacobus.jansen@mumc.nl.
authors.forename: Jacobus F A
authors.initials: JF
authors.lastname: Jansen
mesh_terms: D000818:Animals; D000927:Anticonvulsants / Q000627:therapeutic use*; D015415:Biomarkers / Q000032:analysis*; D001921:Brain / Q000187:drug effects* / Q000503:physiopathology*; D004827:Epilepsy / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D018377:Neurotransmitter Agents / Q000378:metabolism; D016896:Treatment Outcome
chemical_list: D000927:Anticonvulsants; D015415:Biomarkers; D018377:Neurotransmitter Agents
keywords: Anticonvulsant; Cognitive side effects; Functional MRI; MR spectroscopy; Treatment failure