Document Detail


Cortical excitability in drug-naive patients with partial epilepsy: a cross-sectional study.
MedLine Citation:
PMID:  15596749     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To use paired-pulse transcranial magnetic stimulation (TMS) to investigate cortical excitability in drug-naive patients with partial epilepsy. METHODS: Twenty-one drug-naive patients with partial epilepsy and 15 control subjects were studied. The relaxed threshold to TMS, the central silent period, and the intracortical inhibition/facilitation were measured. Statistics implied cluster analysis methods. Also assessed were the patient interictal EEG epileptiform abnormalities (EAs) on a semiquantitative basis. Then the TMS was contrasted to the clinical and EEG findings, using chi2 or Fisher exact tests. RESULTS: One-third of the patients made up a "pathologic" cluster with a disrupted intracortical inhibition (p < 0.01). Two-thirds had a normal inhibition. Interictal EAs predominated in the pathologic cluster, for frequency (p < 0.04), duration (p < 0.04), and focality (p < 0.02). CONCLUSIONS: Intracortical inhibition, which was impaired in one-third of the patients, reflects gamma-aminobutyric acid (GABA) activity within cortical area 4. Defective GABA inhibition is a typical pathogenic factor in partial epilepsy. Transcranial magnetic stimulation proved able to detect it. The weaker cortical inhibition had a direct relation to the severity of interictal epileptiform abnormalities.
Authors:
C Varrasi; C Civardi; C Boccagni; M Cecchin; R Vicentini; F Monaco; R Cantello
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Neurology     Volume:  63     ISSN:  1526-632X     ISO Abbreviation:  Neurology     Publication Date:  2004 Dec 
Date Detail:
Created Date:  2004-12-14     Completed Date:  2005-08-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0401060     Medline TA:  Neurology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2051-5     Citation Subset:  AIM; IM    
Affiliation:
Department of Medical Sciences, Section of Neurology, Università del Piemonte Orientale A. Avogadro, Novara, Italy.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Cerebral Cortex / physiopathology*
Cross-Sectional Studies
Electroencephalography
Epilepsies, Partial / physiopathology*
Female
Humans
Magnetics / diagnostic use*
Male
Middle Aged
gamma-Aminobutyric Acid / physiology
Chemical
Reg. No./Substance:
56-12-2/gamma-Aminobutyric Acid

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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