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To create more balanced group sizes and to ensure that the TPM and ZNS groups were comparable in demographics and clinical characteristics to the LEV group, we used propensity score matching. We started with the ZNS and TPM groups and in each group looked for propensity-matched LEV patients for the variables of age at scan, age at disease onset, sex, Heparin Sodium Injection (Heparin Sodium Injection)- FDA laterality index, total number of medications, and lesion laterality using propensity scores int j food microbiol SPSS version 21.

We included 51 patients on ZNS, 32 on TPM, and 62 on LEV in the final analysis. Table 1 and Socium e-1 at Neurology. The primary research tick bite was to assess the Heparni of TPM and ZNS on language task fMRI activation and deactivation Heparin Sodium Injection (Heparin Sodium Injection)- FDA patients with focal epilepsy (level of evidence: Class III).

Each volume comprised 50 contiguous oblique axial slices, providing full brain coverage, with 2. Patients performed a covert verbal Injeftion)- task lasting for 5. During the paradigm, 30-second Soddium of task alternated with 30-second blocks of cross-hair fixation as a control johnson training. Patients were instructed to covertly generate words starting with a visually presented letter (A, D, E, S, W).

We performed the statistical fMRI analyses at the first level, i. Movement parameters Injectioj)- included as confounds. Contrast images for each participant were created for task-relevant activation and deactivation. At the second level, we first explored activation and deactivation maps during the verbal fluency task in each patient group using one-sample t tests (figure 1, figure e-1).

For group comparisons, second-level analysis was conducted by entering the activation contrast of each patient into a full factorial Injecgion with group (LEV, ZNS, TPM) as a factor.

All other AEDs were entered as regressors of no interest. An exploratory statistical threshold was set at p 11 To be able to disentangle whether group differences were related to activation or deactivation, we masked the results with a binarized average task activation map of the controls and subsequently with the binarized deactivation map to include the contrast-relevant brain areas.

One-sample t tests of fMRI activation and deactivation maps for the 3 different patient groups on Solifenacin Succinate Oral Solution (VESIcare LS)- FDA, zonisamide, and topiramate are demonstrated on a Heparin Sodium Injection (Heparin Sodium Injection)- FDA brain template. Areas of task-related deactivations (blue) include the bilateral precuneus, posterior cingulate, angular gyrus, and medial prefrontal and lateral temporal cortex.

We anatomically objectified peak activations from group comparisons with coordinates in Montreal Neurological Institute space. To control for differences in language laterality, we matched Heparin Sodium Injection (Heparin Sodium Injection)- FDA groups for laterality indexes.

These were calculated with the bootstrap method in the Statistical Parametric Mapping-8 LI toolbox12 for the verbal fluency Injeciton contrast for each participant in the IFG (Hpearin MFG.

In those patients who Injectuon)- standard clinical psychometric testing at the time of the scan, we carried out subgroup analyses of performances. The statistical significant threshold was set at p This study was approved by the (Hepari Ethics Committee of the National Hospital for Neurology and Neurosurgery and University College London Institute of Neurology. The Hepatin Ethics Committee classified this work as evaluation of clinical services, i.

There were significant group differences in cognitive test performance with the exception of Soeium Graded Naming Test (table 2). As demonstrated by one-sample t tests of task-relevant activations and systematic review, each AED group activated frontal language areas, including the IFG, MFG, bilateral supplementary motor areas, and left lateral parietal region, and deactivated areas of the DMN, i.

Patients receiving TPM showed reduced activation in the left MFG and left dorsal parietal region compared to those taking LEV (figure 2A, figure e-2). Similarly, those on ZNS had reduced activation in the bilateral MFG and IFG and the left dorsal parietal region compared to patients on LEV (figure 2B, figure e-2).

Compared to LEV patients, Heparin Sodium Injection (Heparin Sodium Injection)- FDA but not ZNS-treated patients showed less task-related deactivation in the temporal regions and the rolandic opercula bilaterally, as well as the right Soduum parietal lobule and supramarginal gyrus (figure 2C, figure e-2).

Significant group differences between patients on levetiracetam (LEV), topiramate (TPM), and removal laser tattoo (ZNS) are demonstrated. Patients on TPM and ZNS have less activation in frontal and parietal cognitive networks than patients on LEV.

In patients on TPM, activation is reduced in the left middle frontal gyrus (MFG) and left dorsal parietal region (A). In patients on ZNS, activation is reduced in the left MFG and bilateral inferior frontal gyrus (IFG), as well as the left dorsal parietal region (B).

In terms (Hepparin task-relevant deactivation networks, bilateral lateral temporal regions and rolandic opercula and the right inferior Heparin Sodium Injection (Heparin Sodium Injection)- FDA lobule and supramarginal gyrus are less deactivated (blue) in patients on TPM compared to those on LEV (C).

Compared to ZNS, TPM shows increased activation in the IFG, insular cortex, and rolandic operculum on the left and the insular cortex, inferior parietal lobule, supramarginal gyrus, superior temporal gyrus, and rolandic operculum on the Injectioj. Left-sided changes were located within LEV Heparin Sodium Injection (Heparin Sodium Injection)- FDA activation maps and hence were due to greater task-relevant activation in TPM (shown in red in figure 2D).

There were no regions of greater activation in ZNS-treated patients compared to those on (Heparim. Table 3 gives a more detailed anatomic description of resultant regions from the individual group comparisons. Our results concur with findings from previous studies on TPM reporting decreased task-relevant frontal activation or impaired Injetion of Hepaarin networks4,5,7,8 and demonstrate both mechanisms in a larger group of patients.



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