Effects of Bumetanide on Neuro-Cognitive Functioning in Drug- Resistant Epilepsy

Background and Aim: Antiepileptic drugs (AEDs) have repeatedly shown inconsistent and almost contradictory effects on the neurocognitive system, from substantial impairments in processing speed to the noticeable improvement in working memory and executive functioning. We investigated effect of Bumetanide, an NKCC۱ cotransporter antagonist, on the brain microstructural organization as a probable underlying component for cognitive performance. Methods: Microstructure assessment was completed using SPM for the whole brain assay and Freesurfer/TRACULA for the automatic probabilistic tractography analysis. Primary cognitive operations including selective attention and processing speed, working memory capacity and spatial memory were evaluated in twelve patients with a confirmed diagnosis of refractory epilepsy. Participants treated with bumetanide (۲mg/day) in two divided doses as an adjuvant therapy to their regular AEDs for six months, which followed by the re-assessment of their cognitive functions and microstructural organizations. Results: effect of Bumetanide on cognitive performance in TLE patients. Conclusion: The voxel-based analysis in responder patients revealed increased FA in the left hippocampus, right cerebellum, and right medial temporal lobe, while mean diffusivity (MD) values reduced in the right occipital lobe and cerebellum. Microstructural changes in SLFt and ATR accompanied by a reduction in the error rate in the spatial memory test.

کلیدواژه ها:

epilepsy ، bumetanide ، cognition