Homeostatic effects of plasma valproate levels on corticospinal excitability changes induced by 1Hz rTMS in patients with juvenile myoclonic epilepsy

Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology
F FregniKette Valente

Abstract

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. 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. 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. Our findings can be ...Continue Reading

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Citations

Apr 1, 2009·Neurotherapeutics : the Journal of the American Society for Experimental NeuroTherapeutics·Michael A Nitsche, Walter Paulus
Oct 1, 2007·Neuromodulation : Journal of the International Neuromodulation Society·Christopher C Hemond, Felipe Fregni
Aug 14, 2012·Neuromodulation : Journal of the International Neuromodulation Society·Mauricio Fernando VillamarRoss Zafonte
Mar 19, 2009·Journal of Neuroengineering and Rehabilitation·Nadia BologniniFelipe Fregni
Aug 13, 2015·Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology·Michael A Nitsche
Sep 3, 2008·Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology·Jean-Pascal Lefaucheur
Mar 14, 2016·Epilepsy & Behavior : E&B·Luisa Santos PereiraFelipe Fregni
Sep 9, 2010·European Journal of Pain : EJP·Felipe FregniAlvaro Pascual-Leone
Dec 3, 2014·Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology·Jung Min HwangWon Hyuk Chang
Oct 14, 2014·Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology·Magdalena Sarah VolzFelipe Fregni
Oct 29, 2013·Translational Neuroscience·Thilinie Rajapakse, Adam Kirton
Dec 17, 2014·Brain Stimulation·Chandramouli KrishnanMargaret Ehinger
Jun 3, 2016·Expert Review of Neurotherapeutics·Sofie CarretteKristl Vonck
Jul 17, 2010·Brain Stimulation·Mustafa A MuftiWilliam M McDonald
Dec 31, 2009·The Neuroscientist : a Review Journal Bringing Neurobiology, Neurology and Psychiatry·Soroush ZaghiFelipe Fregni
Jun 15, 2007·Nature Reviews. Neuroscience·Michael C Ridding, John C Rothwell
Mar 7, 2020·Journal of Clinical Neurophysiology : Official Publication of the American Electroencephalographic Society·Fiona M BaumerRobert S Fisher

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