Cortical Excitability in Patients After Loading Doses of Lamotrigine: A Study with Magnetic Brain Stimulation

Summary: Purpose: Transcranial magnetic stimulation (TMS) of the brain allows the pharmacologic effects of anti‐convulsant drugs (AEDs) on the excitability of motor cortico‐spinal pathways to be evaluated in patients with epilepsy and normal subjects. However, no study has yet documented the changes in motor excitability in patients treated with lamotrigine (LTG). We aimed to study the effects of loading doses of LTG on TMS recordings in patients with epilepsy at the beginning of their treatment.

[1]  R. Michelucci,et al.  Transcranial magnetic stimulation in epileptic patients , 1990, Neurology.

[2]  G. Thickbroom,et al.  The muscle silent period following transcranial magnetic stimulation , 1992 .

[3]  G. Zanette,et al.  Crossed and direct effects of digital nerves stimulation on motor evoked potential: a study with magnetic brain stimulation. , 1997, Electroencephalography and clinical neurophysiology.

[4]  A. Schulze-Bonhage,et al.  Effects of carbamazepine on cortical excitatory and inhibitory phenomena: a study with paired transcranial magnetic stimulation. , 1996, Electroencephalography and clinical neurophysiology.

[5]  F. Matsuo,et al.  Placebo‐controlled study of the efficacy and safety of lamotrigine in patients with partial seizures , 1993, Neurology.

[6]  G Zanette,et al.  Reversible changes of motor cortical outputs following immobilization of the upper limb. , 1997, Electroencephalography and clinical neurophysiology.

[7]  E Marg,et al.  Finding the depth of magnetic brain stimulation: a re-evaluation. , 1994, Electroencephalography and clinical neurophysiology.

[8]  B. Day,et al.  The effect of magnetic coil orientation on the latency of surface EMG and single motor unit responses in the first dorsal interosseous muscle. , 1994, Electroencephalography and clinical neurophysiology.

[9]  M. Leach,et al.  Studies on the mechanism of action of the novel anticonvulsant lamotrigine (Lamictal) using primary neuroglial cultures from rat cortex , 1993, Brain Research.

[10]  C. Binnie,et al.  Double-blind crossover trial of lamotrigine (Lamictal) as add-on therapy in intractable epilepsy , 1989, Epilepsy Research.

[11]  C E Elger,et al.  Magnetic motor‐evoked potentials in epilepsy: Effects of the disease and of anticonvulsant medication , 1990, Annals of neurology.

[12]  B. Steinhoff,et al.  Effects of antiepileptic drugs on motor cortex excitability in humans: A transcranial magnetic stimulation study , 1996, Annals of neurology.

[13]  S. Pullman,et al.  Physiological basis of voluntary activity inhibition induced by transcranial cortical stimulation. , 1993, Electroencephalography and clinical neurophysiology.

[14]  M. Leach.  Lamotrigine: mechanisms of action , 1995 .

[15]  P. Rossini,et al.  Non-invasive electrical and magnetic stimulation of the brain, spinal cord and roots: basic principles and procedures for routine clinical application. Report of an IFCN committee. , 1994, Electroencephalography and clinical neurophysiology.

[16]  N Mavroudakis,et al.  Effects of vigabatrin on motor potentials evoked with magnetic stimulation. , 1997, Electroencephalography and clinical neurophysiology.

[17]  T. Sawaguchi,et al.  GABAergic inhibition of neuronal activity in the primate motor and premotor cortex during voluntary movement. , 1992, Journal of neurophysiology.

[18]  D C Reutens,et al.  Magnetic stimulation of the brain in generalized epilepsy: Reversal of cortical hyperexcitability by anticonvulsants , 1993, Annals of neurology.

[19]  R. J. Lockwood,et al.  The muscle silent period following transcranial magnetic cortical stimulation , 1993, Journal of the Neurological Sciences.

[20]  N Accornero,et al.  Motor cortical inhibition and the dopaminergic system. Pharmacological changes in the silent period after transcranial brain stimulation in normal subjects, patients with Parkinson's disease and drug-induced parkinsonism. , 1994, Brain : a journal of neurology.

[21]  P. Rossini,et al.  'Excitability changes of muscular responses to magnetic brain stimulation in patients with central motor disorders. , 1991, Electroencephalography and clinical neurophysiology.

[22]  C. Zona,et al.  Lamotrigine Reduces Voltage‐Gated Sodium Currents in Rat Central Neurons in Culture , 1997, Epilepsia.

[23]  M. Hallett,et al.  Optimal Focal Transcranial Magnetic Activation of the Human Motor Cortex: Effects of Coil Orientation, Shape of the Induced Current Pulse, and Stimulus Intensity , 1992, Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society.

[24]  M. Hallett,et al.  Spinal motor neuron excitability during the silent period after cortical stimulation. , 1991, Electroencephalography and clinical neurophysiology.

[25]  E. Brunko,et al.  Effects of diphenylhydantoin on motor potentials evoked with magnetic stimulation. , 1994, Electroencephalography and clinical neurophysiology.