Effects of topiramate on neurophysiological and neuropsychological tests in migraine patients

Kececi, Hulusi; Atakay, Selcuk

doi:10.1016/j.jocn.2009.03.025

Cited by 21 publications

(14 citation statements)

References 28 publications

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“…The use of topiramate was noted in 18% of migraineurs in this study. Complaints of cognitive dysfunction with topiramate in healthy individuals and migraine patients were corroborated by a documented decrease in attention, memory and psychomotor speed in previous studies. This could be an important bias in our sample, but regression analysis failed to relate the use of topiramate to a higher score in Mig‐SCog.…”

Section: Discussionsupporting

confidence: 65%

Clinical Utility of the Mig‐SCog

2016

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Attack-related subjective cognitive symptoms, assessed by Mig-SCog scores, differed between migraine and TTH patients. The Mig-SCog scores from migraine patients were found to be higher during migraine than during non-headache pain or pain-free conditions. Patient scoring from memory for usual attacks was not significantly different to scoring within attacks, We believe this demonstrates negligible recall bias.

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Section: Discussionsupporting

confidence: 65%

Clinical Utility of the Mig‐SCog

2016

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“…VMR is important for the autonomic and hemodynamic functioning of the cerebrum (7,8,19,27,29) and we think that it can be helpful in following up the efficacy of migraine prophylaxis. Topiramate (TPM) is an antiepileptic with broad-spectrum and multiple mechanisms of action, and is used as a prophylactic treatment for migraine (17,21). The present study aimed to evaluate the efficacy of TPM treatment on the frequency and duration of migraine attacks, visual analog scale (VAS) score, VMR (from both the right and left MCA, and PCA), and cerebral blood flow in migraine with aura patients.…”

Section: Introductionmentioning

confidence: 99%

The effects of topiramate therapy on cerebral metabolism in migraine with aura patients

Karadaş

Gül²,

Öztürk³

et al. 2014

Turkish Neurosurgery

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AIm:Topiramate is an antiepileptic drug with multiple mechanisms of action that is also used for migraine prophylaxis. This study aimed to investigate the efficacy of topiramate therapy for migraine prophylaxis, based on vasomotor reactivity ([VMR] an indicator of cerebral autoregulation), and to identify changes in cerebral hemodynamics during the treatment. mATERIAL and mETHods:We included 20 migraine (with aura) patients (group 1) and 20 healthy controls (group 2) in the study. Transcranial Doppler monitoring was performed in both groups with patients in the supine and resting position. Using a two-sided temporal window at depths of 45-60 mm for the middle cerebral artery (MCA) and depths of 60-70 mm for the posterior cerebral artery (PCA), basal flow rates and VMR values were measured. Group 1 initially received 25 mg/d of topiramate orally, and then the dose was increased 25 mg every week. At the fourth week; the optimal dose was increased to 50 mg b.i.d. and the treatment was continued at this dose. Transcranial Doppler parameters were re-evaluated 2 months after treatment. In addition, the number of attacks per month, duration of pain, and visual analog scale (VAS) scores obtained before the treatment and 2 months after the treatment in group 1 were compared.REsuLTs: Basal flow rates and VMR values recorded from the right and left MCA in group 1 were significantly higher than those in the control group (P < 0.05). Flow velocities obtained from the right and left MCA, and the VMR values in group 1 after topiramate treatment did not differ significantly from those in the control group (P > 0.05). In addition, the number of attacks, duration of pain, and VAS scores in group 1 were significantly lower after the treatment than before the treatment (P < 0.05). CoNCLusIoN:Topiramate is an effective prophylactic treatment in migraine with aura patients and appeared to play a positive role in the regulation of cerebrovascular autonomic control. BuLGuLAR: Topiramat tedavisi öncesi migren grubunda OSA bazal akım hızları ile VMR değerleri istatistiksel olarak anlamlı derecede (p<0,05) yüksek bulundu. Migren grubunda topiramat tedavi sonrası saptanan, sağ ve sol OSA'dan elde edilen bazal akım hızları ile VMR değerleri, kontrol grubu ile karşılaştırıldığında farklılık saptanmadı (p>0,05).soNuÇ: Migrenli hastaların proflaktik tedavisinde, topiramatın iyi bir seçenek olduğu ve serebrovasküler otonomik kontrolün regülasyonunda rol oynadığı söylenebilir.

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“…Cognitive side effects of topiramate are well known and have been described in epilepsy patients [27], migraineurs [28] and healthy subjects [29]. These deficits are reported after single-dose treatment and on steady-dose and encompass reduced attention, psychomotor-speed, working memory and language impairment [29].…”

Section: Discussionmentioning

confidence: 99%

Topiramate modulates trigeminal pain processing in thalamo-cortical networks in humans after single dose administration

Hebestreit

May

2017

PLoS ONE

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Migraine is the sixth most common cause of disability in the world. Preventive migraine treatment is used to reduce frequency, severity and duration of attacks and therefore lightens the burden on the patients’ quality of life and reduces disability. Topiramate is one of the preventive migraine treatments of proven efficacy. The mechanism of action underlying the preventive effect of topiramate in migraine remains largely unknown. Using functional magnetic resonance imaging (fMRI) we examined the central effects of a single dose of topiramate (100mg) on trigeminal pain in humans, compared to placebo (mannitol). In this prospective, within subject, randomized, placebo-controlled and double-blind study, 23 healthy participants received a standardized nociceptive trigeminal stimulation and control stimuli whilst being in the scanner. No differences in the subjective intensity ratings of the painful stimuli were observed between topiramate and placebo sessions. In contrast, topiramate significantly decreased the activity in the thalamus and other pain processing areas. Additionally, topiramate increased functional coupling between the thalamus and several brain regions such as the bilateral precuneus, posterior cingulate cortex and secondary somatosensory cortex. These data suggest that topiramate exhibits modulating effects on nociceptive processing in thalamo-cortical networks during trigeminal pain and that the preventive effect of topiramate on frequent migraine is probably mediated by an effect on thalamo-cortical networks.

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Effects of topiramate on neurophysiological and neuropsychological tests in migraine patients

Cited by 21 publications

References 28 publications

Clinical Utility of the Mig‐SCog

Clinical Utility of the Mig‐SCog

The effects of topiramate therapy on cerebral metabolism in migraine with aura patients

Topiramate modulates trigeminal pain processing in thalamo-cortical networks in humans after single dose administration

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