Joo Eun Yeon, Kim Sun Hwa, Seo Dae Won, Hong Seung Bong
Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, Seoul 135-710, Republic of Korea.
Clin Neurophysiol. 2008 Jun;119(6):1385-92. doi: 10.1016/j.clinph.2008.02.008. Epub 2008 Apr 8.
To evaluate changes in cortical excitability after long-term zonisamide (ZNS) administration.
Fifteen drug-naïve idiopathic generalized epilepsy (IGE) patients (8 male, mean age 24.9 years) were enrolled. The transcranial magnetic stimulation (TMS) parameters obtained using two Magstim 200 stimulators were resting motor threshold (RMT), motor evoked potential (MEP) amplitudes, cortical silent period (CSP), intracortical inhibition (ICI), and intracortical facilitation (ICF). TMS parameters were compared before and after ZNS administration.
All patients were administered ZNS monotherapy (200 mg/day) for 8 weeks. No patient reported seizures during the study period. After ZNS treatment MEP amplitudes were significantly reduced in right (-34.2%) and left hemispheres (-37.0%) (Wilcoxon's signed rank test after Bonferroni's correction for multiple comparisons, P < 0.05). Mean RMT, CSP, and ICI/ICF were not changed by ZNS (P > 0.05).
These findings suggest that ZNS decreases cortical excitability in patients with IGE and a MEP amplitude is a useful TMS parameter for evaluating changes in cortical excitability induced by ZNS.
The findings in this study are helpful to understand how ZNS affects the excitability of the motor cortex in patients with IGE.
评估长期服用唑尼沙胺（ZNS）后皮质兴奋性的变化。
纳入15例未服用过药物的特发性全身性癫痫（IGE）患者（8例男性，平均年龄24.9岁）。使用两台Magstim 200刺激器获得的经颅磁刺激（TMS）参数包括静息运动阈值（RMT）、运动诱发电位（MEP）幅度、皮质静息期（CSP）、皮质内抑制（ICI）和皮质内易化（ICF）。比较ZNS给药前后的TMS参数。
所有患者接受ZNS单药治疗（200mg/天）8周。研究期间无患者报告癫痫发作。ZNS治疗后，右半球（-34.2%）和左半球（-37.0%）的MEP幅度显著降低（经Bonferroni校正用于多重比较的Wilcoxon符号秩检验，P<0.05）。ZNS对平均RMT、CSP和ICI/ICF无影响（P>0.05）。
这些发现表明ZNS可降低IGE患者的皮质兴奋性，MEP幅度是评估ZNS诱导的皮质兴奋性变化的有用TMS参数。
本研究结果有助于了解ZNS如何影响IGE患者运动皮质的兴奋性。
