PURPOSE:Lacosamide (LCM) and carbamazepine (CBZ) are antiepileptic drugs both acting on neuronal voltage-gated sodium channels. Patch-clamp studies demonstrated significant differences in how LCM and CBZ affect neuronal membrane excitability. Despite valuable information patch-clamp studies provide, they also comprise some constraints. For example, little is known about effects of LCM on intracortical synaptic excitability. In contrast, transcranial magnetic stimulation (TMS) can describe drug-induced changes at the system level of the human cerebral cortex. METHODS: The present study was designed to explore dose-depended effects of LCM and effects of CBZ on motor cortex excitability with TMS in a randomized, double-blind, placebo-controlled crossover trial in healthy human subjects. Subjects received 600 mg CBZ, 200 mg LCM, 400 mg LCM or placebo preceding TMS measurements. RESULTS: Compared to placebo, TMS motor thresholds were significantly increased after carbamazepine and lacosamide, with a trend for a dose dependent effect of lacosamide. Both, carbamazepine and lacosamide did not affect TMS parameters of intracortical synaptic excitability. CONCLUSIONS: TMS measurements suggest that lacosamide and carbamazepine predominantly act on neuronal membrane excitability.
RCT Entities:
PURPOSE:Lacosamide (LCM) and carbamazepine (CBZ) are antiepileptic drugs both acting on neuronal voltage-gated sodium channels. Patch-clamp studies demonstrated significant differences in how LCM and CBZ affect neuronal membrane excitability. Despite valuable information patch-clamp studies provide, they also comprise some constraints. For example, little is known about effects of LCM on intracortical synaptic excitability. In contrast, transcranial magnetic stimulation (TMS) can describe drug-induced changes at the system level of the human cerebral cortex. METHODS: The present study was designed to explore dose-depended effects of LCM and effects of CBZ on motor cortex excitability with TMS in a randomized, double-blind, placebo-controlled crossover trial in healthy human subjects. Subjects received 600 mg CBZ, 200 mg LCM, 400 mg LCM or placebo preceding TMS measurements. RESULTS: Compared to placebo, TMS motor thresholds were significantly increased after carbamazepine and lacosamide, with a trend for a dose dependent effect of lacosamide. Both, carbamazepine and lacosamide did not affect TMS parameters of intracortical synaptic excitability. CONCLUSIONS: TMS measurements suggest that lacosamide and carbamazepine predominantly act on neuronal membrane excitability.
Authors: Mehdi A J van den Bos; Nimeshan Geevasinga; Mana Higashihara; Parvathi Menon; Steve Vucic Journal: Int J Mol Sci Date: 2019-06-10 Impact factor: 5.923
Authors: Robert M Helling; Sharon Shmuely; Prisca R Bauer; Else A Tolner; Gerhard H Visser; Roland D Thijs Journal: Ann Clin Transl Neurol Date: 2022-03-17 Impact factor: 4.511
Authors: Isabella Premoli; Pierre G Rossini; Paul Y Goldberg; Kristina Posadas; Louise Green; Noah Yogo; Simon Pimstone; Eugenio Abela; Gregory N Beatch; Mark P Richardson Journal: Ann Clin Transl Neurol Date: 2019-09-30 Impact factor: 4.511