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Cortical excitability during prolonged antiepileptic drug treatment and drug withdrawal

Title
Cortical excitability during prolonged antiepileptic drug treatment and drug withdrawal
Authors
Lee H.W.Seo H.J.Cohen L.G.Bagic A.Theodore W.H.
Ewha Authors
이향운
SCOPUS Author ID
이향운scopus
Issue Date
2005
Journal Title
Clinical Neurophysiology
ISSN
1388-2457JCR Link
Citation
Clinical Neurophysiology vol. 116, no. 5, pp. 1105 - 1112
Indexed
SCI; SCIE; SCOPUS WOS scopus
Document Type
Conference Paper
Abstract
Objective: Previous reports characterized the effects of administration of single oral doses of antiepileptic drugs (AED) on cortical excitability. However, AED effects on cortical excitability, and their relationship to plasma blood levels, during chronic drug administration at therapeutic doses are not known. The objective of the study was to determine whether plasma blood levels during chronic administration at therapeutic doses would accurately predict changes in corticomotor excitability. Methods: We used transcranial magnetic stimulation (TMS) to measure cortical excitability during 5 weeks administration of carbamazepine (CBZ) and lamotrigine (LTG), and subsequent AED withdrawal in 20 healthy volunteers. Data were analyzed using ANOVA RM and regression analysis. Results: Resting motor thresholds (r-MT) increased with increasing total and free CBZ and LTG levels during drug administration, but not drug withdrawal. After acute AED withdrawal, r-MT elevation persisted in most individuals with CBZ despite undetectable plasma levels, compared to a rapid normalization with LTG. In contrast, acute drug withdrawal resulted in a transient decrease in r-MT in 3/10 individuals with CBZ and 2/10 with LTG. Conclusions: Plasma levels provide information on motor cortical function during active treatment phases but not during AED withdrawal. Significance: The transient decrease in r-MT associated with acute AED withdrawal could represent a physiological substrate contributing to AED withdrawal seizures.
DOI
10.1016/j.clinph.2004.12.004
Appears in Collections:
의과대학 > 의학과 > Journal papers
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