title: Resting-state fMRI revealed different brain activities responding to valproic acid and levetiracetam in benign epilepsy with central-temporal spikes.
abstract: OBJECTIVE
  Our aim was to investigate regional difference in brain activities in response to antiepileptic drug (AED) medications in benign epilepsy with central-temporal spikes (BECTS) using resting-state functional magnetic resonance imaging (fMRI).
  
  
  METHODS
  Fifty-seven patients with BECTS underwent resting-state fMRI scans after receiving either valproic acid (VPA) (n = 15), levetiracetam (LEV) (n = 21), or no medication (n = 21). fMRI regional homogeneity (ReHo) parameter among the three groups of patients were compared and were correlated with total doses of AED in the two medicated groups.
  
  
  RESULTS
  Compared with patients on no-medication, patients receiving either VPA or LEV showed decreased ReHo in the central-temporal region, frontal cortex, and thalamus. In particular, the VPA group showed greater ReHo decrease in the thalamus and milder in cortices and caudate heads compared with the LEV group. In addition, the VPA group demonstrated a negative correlation between ReHo values in the central-temporal region and medication dose.
  
  
  CONCLUSIONS
  Both VPA and LEV inhibit resting-state neural activity in the central-temporal region, which is the main epileptogenic focus of BECTS. VPA reduced brain activity in the cortical epileptogenic regions and thalamus evenly, whereas LEV reduced brain activity predominantly in the cortices. Interestingly, VPA showed a cumulative effect on inhibiting brain activity in the epileptogenic regions in BECTS.
  
  
  CONCLUSIONS
  • Regional differences in brain activity in response to different AEDs in BECTS. • AEDs inhibit resting-state neural activity in epileptogenic and subcortical regions in BECTS. • Valproic acid effect on the cortical epileptogenic regions and thalamus evenly. • Levetiracetam effect seen predominantly in cortices. • Valproic acid has a cumulative effect on inhibiting brain activity in epileptogenic regions.
authors.affiliation: Department of Medical Imaging, Jinling Hospital, Nanjing University School of Medicine, 305#, Eastern Zhongshan Rd, Nanjing, 210002, China.
authors.forename: Qirui
authors.initials: Q
authors.lastname: Zhang
authors.affiliation: Department of Neurology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, 210002, China.
authors.forename: Fang
authors.initials: F
authors.lastname: Yang
authors.affiliation: Department of Neurology, Nanjing Children's Hospital, Nanjing, 210029, China.
authors.forename: Zheng
authors.initials: Z
authors.lastname: Hu
authors.affiliation: Department of Medical Imaging, Jinling Hospital, Nanjing University School of Medicine, 305#, Eastern Zhongshan Rd, Nanjing, 210002, China. zhangzq2001@126.com.
authors.forename: Zhiqiang
authors.identifier: http://orcid.org/0000-0002-3993-7330
authors.initials: Z
authors.lastname: Zhang
authors.affiliation: Department of Medical Imaging, Jinling Hospital, Nanjing University School of Medicine, 305#, Eastern Zhongshan Rd, Nanjing, 210002, China.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Xu
authors.affiliation: Faculty of Kinesiology and Rehabilitation Sciences, KU Leuven, Belgium.
authors.forename: Mantini
authors.initials: M
authors.lastname: Dante
authors.affiliation: Department of Medical Imaging, Jinling Hospital, Nanjing University School of Medicine, 305#, Eastern Zhongshan Rd, Nanjing, 210002, China.
authors.forename: Han
authors.initials: H
authors.lastname: Wu
authors.affiliation: Department of Medical Imaging, Jinling Hospital, Nanjing University School of Medicine, 305#, Eastern Zhongshan Rd, Nanjing, 210002, China.
authors.forename: Zhipeng
authors.initials: Z
authors.lastname: Li
authors.affiliation: Department of Neurology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, 210002, China.
authors.forename: Qian
authors.initials: Q
authors.lastname: Li
authors.affiliation: Laboratory of Molecular Medicine, Suzhou University, Suzhou, 215000, China.
authors.forename: Kai
authors.initials: K
authors.lastname: Li
authors.affiliation: Department of Medical Imaging, Jinling Hospital, Nanjing University School of Medicine, 305#, Eastern Zhongshan Rd, Nanjing, 210002, China. cjr.luguangming@vip.163.com.
authors.forename: Guangming
authors.initials: G
authors.lastname: Lu
mesh_terms: D000927:Anticonvulsants / Q000008:administration & dosage / Q000494:pharmacology* / Q000627:therapeutic use; D001921:Brain / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000503:physiopathology; D002648:Child; D004305:Dose-Response Relationship, Drug; D004569:Electroencephalography; D004827:Epilepsy / Q000188:drug therapy / Q000503:physiopathology*; D005260:Female; D005625:Frontal Lobe / Q000000981:diagnostic imaging / Q000187:drug effects / Q000503:physiopathology; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D000077287:Levetiracetam; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D010889:Piracetam / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000494:pharmacology / Q000627:therapeutic use; D013702:Temporal Lobe / Q000000981:diagnostic imaging / Q000187:drug effects / Q000503:physiopathology; D013788:Thalamus / Q000000981:diagnostic imaging / Q000187:drug effects / Q000503:physiopathology; D014635:Valproic Acid / Q000008:administration & dosage / Q000494:pharmacology* / Q000627:therapeutic use
chemical_list: D000927:Anticonvulsants; D000077287:Levetiracetam; D014635:Valproic Acid; D010889:Piracetam
keywords: BECTS; Levetiracetam; ReHo; Resting-state fMRI; Valproic acid