Anti-Seizure Medications Alter the Brain’s Network Topology

Abstract

AbstractObjectivesAfter a first epileptic seizure, anti-seizure medications (ASM) change the likelihood of having a further event. This prospective study aimed to quantify the brain network changes associated with the administration of ASM monotherapy.MethodsWe applied graph theoretical network analysis to longitudinal resting-state functional MRI (fMRI) data from 28 participants who had recently experienced their first seizure. Participants were imaged before and after ASM administration (on average, ∼7 months between scans).ResultsAfter commencing ASM, we observed an increase in the clustering coefficient and a decrease in path length, suggesting a normalisation of brain networks. Individually, increased network small-worldness was observed in 75% (21/28) of subjects. Brain changes after ASM treatment were most prominent in superior frontoparietal and inferior frontal and temporal regions, associated with cognitive functions such as working memory and language.DiscussionThis proof-of-principle study suggests that ASM may normalize brain networks and could be a starting point for developing objective imaging markers for monitoring ASM response. Larger studies are required to understand further the connection between ASM-related brain network changes and long-term seizure status and epilepsy diagnosis.