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Cortical excitability measured with transcranial magnetic stimulation in children with epilepsy before and after antiepileptic drugs
Univ Gothenburg, Sweden.
Univ Gothenburg, Sweden.
Univ Gothenburg, Sweden.
Linköping University, Department of Biomedical and Clinical Sciences, Division of Neurobiology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Clinical Neurophysiology. Linköping University, Center for Medical Image Science and Visualization (CMIV).
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2020 (English)In: Developmental Medicine & Child Neurology, ISSN 0012-1622, E-ISSN 1469-8749Article in journal (Refereed) Epub ahead of print
Abstract [en]

Aim To evaluate cortical excitability with transcranial magnetic stimulation (TMS) in children with new-onset epilepsy before and after antiepileptic drugs (AEDs). Method Fifty-five drug-naive patients (29 females, 26 males; 3-18y), with new-onset epilepsy were recruited from 1st May 2014 to 31st October 2017 at the Child Neurology Department, Queen Silvias Childrens Hospital, Gothenburg, Sweden. We performed TMS in 48 children (23 females, 25 males; mean [SD] age 10y [3y], range 4-15y) with epilepsy (27 generalized and 21 focal) before and after the introduction of AEDs. We used single- and paired-pulse TMS. We used single-pulse TMS to record resting motor thresholds (RMTs), stimulus-response curves, and cortical silent periods (CSPs). We used paired-pulse TMS to record intracortical inhibition and facilitation at short, long, and intermediate intervals. Results There were no differences in cortical excitability between children with generalized and focal epilepsy at baseline. After AED treatment, RMTs increased (p=0.001), especially in children receiving sodium valproate (p=0.005). CSPs decreased after sodium valproate was administered (p=0.050). As in previous studies, we noted a negative correlation between RMT and age in our study cohort. Paired-pulse TMS could not be performed in most children because high RMTs made suprathreshold stimulation impossible. Interpretation Cortical excitability as measured with RMT decreased after the introduction of AEDs. This was seen in children with both generalized and focal epilepsy who were treated with sodium valproate, although it was most prominent in children with generalized epilepsy. We suggest that TMS might be used as a prognostic tool to predict AED efficacy.

Place, publisher, year, edition, pages
WILEY , 2020.
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Pediatrics
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URN: urn:nbn:se:liu:diva-164080DOI: 10.1111/dmcn.14490ISI: 000513561800001PubMedID: 32064586OAI: oai:DiVA.org:liu-164080DiVA, id: diva2:1411821
Note

Funding Agencies|Drottning Silvias Jubileums Foundations

Available from: 2020-03-04 Created: 2020-03-04 Last updated: 2020-04-09

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The full text will be freely available from 2021-02-16 11:21
Available from 2021-02-16 11:21

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Thordstein, Magnus
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Division of NeurobiologyFaculty of Medicine and Health SciencesDepartment of Clinical NeurophysiologyCenter for Medical Image Science and Visualization (CMIV)
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Developmental Medicine & Child Neurology
Pediatrics

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