OBJECTIVE: The preliminary results of noninvasive brain stimulation for epilepsy treatment have been encouraging, but mixed. Two important factors may contribute to this heterogeneity: the altered brain physiology of patients with epilepsy and the variable presence of antiepileptic drugs. Therefore, we aimed to study the effects of 1 Hz rTMS on corticospinal excitability in patients with juvenile myoclonic epilepsy (JME) in two different conditions: low- or high-plasma valproate levels. METHODS: Fifteen patients with JME and 12 age-matched healthy subjects participated in this study. Corticospinal excitability before and after 1 Hz rTMS was assessed in JME patients with low- and high-plasma valproate levels; and these results were compared with those in healthy subjects. RESULTS: In patients with chronic use of valproate and low-plasma concentrations, 1 Hz rTMS had a similar significant inhibitory effect on corticospinal excitability as in healthy subjects. However, in the same patients when the serum valproate concentration was high, 1 Hz rTMS increased the corticospinal excitability significantly. In addition, there was a significant positive correlation between plasma valproate levels and the motor threshold changes after 1 Hz rTMS. CONCLUSIONS: Our findings can be accounted for by mechanisms of homeostatic plasticity and illustrate the dependency of the modulatory effects of rTMS on the physiologic state of the targeted brain cortex. SIGNIFICANCE: The therapeutic use of rTMS in epilepsy should take into consideration the interaction between rTMS and drugs that change cortical excitability.
OBJECTIVE: The preliminary results of noninvasive brain stimulation for epilepsy treatment have been encouraging, but mixed. Two important factors may contribute to this heterogeneity: the altered brain physiology of patients with epilepsy and the variable presence of antiepileptic drugs. Therefore, we aimed to study the effects of 1 Hz rTMS on corticospinal excitability in patients with juvenile myoclonic epilepsy (JME) in two different conditions: low- or high-plasma valproate levels. METHODS: Fifteen patients with JME and 12 age-matched healthy subjects participated in this study. Corticospinal excitability before and after 1 Hz rTMS was assessed in JMEpatients with low- and high-plasma valproate levels; and these results were compared with those in healthy subjects. RESULTS: In patients with chronic use of valproate and low-plasma concentrations, 1 Hz rTMS had a similar significant inhibitory effect on corticospinal excitability as in healthy subjects. However, in the same patients when the serum valproate concentration was high, 1 Hz rTMS increased the corticospinal excitability significantly. In addition, there was a significant positive correlation between plasma valproate levels and the motor threshold changes after 1 Hz rTMS. CONCLUSIONS: Our findings can be accounted for by mechanisms of homeostatic plasticity and illustrate the dependency of the modulatory effects of rTMS on the physiologic state of the targeted brain cortex. SIGNIFICANCE: The therapeutic use of rTMS in epilepsy should take into consideration the interaction between rTMS and drugs that change cortical excitability.
Authors: Andre Russowsky Brunoni; Michael A Nitsche; Nadia Bolognini; Marom Bikson; Tim Wagner; Lotfi Merabet; Dylan J Edwards; Antoni Valero-Cabre; Alexander Rotenberg; Alvaro Pascual-Leone; Roberta Ferrucci; Alberto Priori; Paulo Sergio Boggio; Felipe Fregni Journal: Brain Stimul Date: 2011-04-01 Impact factor: 8.955
Authors: Hamed Ekhtiari; Hosna Tavakoli; Giovanni Addolorato; Chris Baeken; Antonello Bonci; Salvatore Campanella; Luis Castelo-Branco; Gaëlle Challet-Bouju; Vincent P Clark; Eric Claus; Pinhas N Dannon; Alessandra Del Felice; Tess den Uyl; Marco Diana; Massimo di Giannantonio; John R Fedota; Paul Fitzgerald; Luigi Gallimberti; Marie Grall-Bronnec; Sarah C Herremans; Martin J Herrmann; Asif Jamil; Eman Khedr; Christos Kouimtsidis; Karolina Kozak; Evgeny Krupitsky; Claus Lamm; William V Lechner; Graziella Madeo; Nastaran Malmir; Giovanni Martinotti; William M McDonald; Chiara Montemitro; Ester M Nakamura-Palacios; Mohammad Nasehi; Xavier Noël; Masoud Nosratabadi; Martin Paulus; Mauro Pettorruso; Basant Pradhan; Samir K Praharaj; Haley Rafferty; Gregory Sahlem; Betty Jo Salmeron; Anne Sauvaget; Renée S Schluter; Carmen Sergiou; Alireza Shahbabaie; Christine Sheffer; Primavera A Spagnolo; Vaughn R Steele; Ti-Fei Yuan; Josanne D M van Dongen; Vincent Van Waes; Ganesan Venkatasubramanian; Antonio Verdejo-García; Ilse Verveer; Justine W Welsh; Michael J Wesley; Katie Witkiewitz; Fatemeh Yavari; Mohammad-Reza Zarrindast; Laurie Zawertailo; Xiaochu Zhang; Yoon-Hee Cha; Tony P George; Flavio Frohlich; Anna E Goudriaan; Shirley Fecteau; Stacey B Daughters; Elliot A Stein; Felipe Fregni; Michael A Nitsche; Abraham Zangen; Marom Bikson; Colleen A Hanlon Journal: Neurosci Biobehav Rev Date: 2019-07-02 Impact factor: 8.989
Authors: Mustafa A Mufti; Paul E Holtzheimer; Charles M Epstein; Sinéad C Quinn; Nancie Vito; William M McDonald Journal: Brain Stimul Date: 2009-09-11 Impact factor: 8.955
Authors: Christian Helfrich; Simone S Pierau; Christine M Freitag; Jochen Roeper; Ulf Ziemann; Stephan Bender Journal: PLoS One Date: 2012-11-21 Impact factor: 3.240