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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 ANOVARM 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.

Titel:	Cortical excitability during prolonged antiepileptic drug treatment and drug withdrawal
Autor/in / Beteiligte Person:	LEE, H. W ; SEO, H. J ; COHEN, L. G ; BAGIC, A ; THEODORE, W. H
Link:	E-Journal im Bestand der UB Hagen? View record from PASCAL Archive
Zeitschrift:	Clinical neurophysiology, Jg. 116 (2005), Heft 5, S. 1105-1112
Veröffentlichung:	Shannon: Elsevier Science, 2005
Medientyp:	academicJournal
Umfang:	print, 1 p.1/4
ISSN:	1388-2457 (print)
Schlagwort:	Neurology Neurologie Sciences biologiques et medicales Biological and medical sciences Sciences medicales Medical sciences Pharmacologie. Traitements medicamenteux Pharmacology. Drug treatments Neuropharmacologie Neuropharmacology Anticonvulsivants. Antiépileptiques. Antiparkinsoniens Anticonvulsants. Antiepileptics. Antiparkinson agents Système nerveux (sémiologie, syndromes) Nervous system (semeiology, syndromes) Syndromes encéphaliques généraux: céphalées, douleurs de la face, syncopes, épilepsie, hypertension intracrânienne, oedème cérébral. Infirmité motrice cérébrale Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy Encéphale pathologie Cerebral disorder Encéfalo patología Encéphale Encephalon Encéfalo Système nerveux central pathologie Central nervous system disease Sistema nervosio central patología Système nerveux central Central nervous system Sistema nervioso central Système nerveux pathologie Nervous system diseases Sistema nervioso patología Analyse régression Regression analysis Análisis regresión Arrêt traitement Treatment withdrawal Paro tratamiento Carbamazépine Carbamazepine Carbamazepina Cortex cérébral Cerebral cortex Corteza cerebral Electrodiagnostic Electrodiagnosis Electrodiagnóstico Epilepsie Epilepsy Epilepsia Excitabilité Excitability Excitabilidad Homme Human Hombre Lamotrigine Lamotrigina Traitement Treatment Tratamiento Voie orale Oral administration Vía oral Stimulation magnétique transcrânienne Transcranial magnetic stimulation Antiepileptic drug treatment Cortical excitability Drug withdrawal Plasma blood levels
Sonstiges:	Nachgewiesen in: PASCAL Archive Sprachen: English Original Material: INIST-CNRS Document Type: Article File Description: text Language: English Author Affiliations: Clinical Epilepsy Section, National Institutes of Neurological Disorders and Stroke, Bethesda, MD, United States ; Department of Neurology, College of Medicine, Ewha Womans University, and Ewha Medical Research Institute, Seoul, Korea, Republic of ; Human Cortical Physiology Section, Medical Neurology Branch, National Institutes of Neurological Disorders and Stroke, Building 10, Room 5N226, Bethesda, MD 20892, United States Rights: Copyright 2005 INIST-CNRS ; CC BY 4.0 ; Sauf mention contraire ci-dessus, le contenu de cette notice bibliographique peut être utilisé dans le cadre d’une licence CC BY 4.0 Inist-CNRS / Unless otherwise stated above, the content of this bibliographic record may be used under a CC BY 4.0 licence by Inist-CNRS / A menos que se haya señalado antes, el contenido de este registro bibliográfico puede ser utilizado al amparo de una licencia CC BY 4.0 Inist-CNRS Notes: Neurology ; Pharmacological treatments ; Psychopathology. Psychiatry. Clinical psychology

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Cortical excitability during prolonged antiepileptic drug treatment and drug withdrawal