Department of Clinical Neurosciences, St Vincent's Hospital, Fitzroy, Australia.
Epilepsy Behav. 2013 Jun;27(3):455-60. doi: 10.1016/j.yebeh.2013.03.015. Epub 2013 Apr 18.
We used transcranial magnetic stimulation (TMS) to investigate motor cortical excitability changes in relation to blood glucose levels.
Twenty-two drug-naïve patients with epilepsy [11 generalized and 11 focal] and 10 controls were studied twice on the same day; first after 12h of fasting and then 2h postprandial. Motor threshold and paired-pulse TMS at a number of short and long interstimulus intervals were measured. Serum glucose levels were measured each time.
Decreased long intracortical inhibition was seen in patients and controls during fasting compared to postprandial studies. This effect was much more prominent in patients with generalized epilepsy (with effect sizes of up to 0.8) in whom there was also evidence of increased intracortical facilitation (effect size: 0.3).
Cortical excitability varies with fluctuations in blood glucose levels. This variation is more prominent in patients with epilepsy. Decreased glucose levels may be an important physiological seizure trigger.
我们使用经颅磁刺激（TMS）来研究与血糖水平相关的运动皮质兴奋性变化。
22 名未经药物治疗的癫痫患者（11 名全身性和 11 名局灶性）和 10 名对照者在同一天进行了两次研究；第一次是在禁食 12 小时后，然后是餐后 2 小时。测量了运动阈值和在多个短和长刺激间隔的成对脉冲 TMS。每次都测量血清葡萄糖水平。
与餐后研究相比，禁食期间患者和对照组的长皮质内抑制降低。这种影响在全身性癫痫患者中更为明显（效应大小高达 0.8），其中也有皮质内易化增加的证据（效应大小：0.3）。
皮质兴奋性随血糖水平波动而变化。这种变化在癫痫患者中更为明显。血糖水平降低可能是一个重要的生理性癫痫发作触发因素。
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