Zonisamide Changes Unilateral Cortical Excitability in Focal Epilepsy Patients
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Background and Purpose:To evaluate changes in cortical excitability induced by zonisamide (ZNS) in focal epilepsy patients. Methods:Twenty-four drug-naїve focal epilepsy patients (15 males; overall mean age 29.8 years)were enrolled. The transcranial magnetic stimulation parameters obtained using two Magstim 200stimulators were the resting motor threshold, amplitude of the motor-evoked potential (MEP),cortical silent period, short intracortical inhibition, and intracortical facilitation. These five transcranial magnetic stimulation parameters were measured before and after ZNS, and the findings were compared. Results:All 24 patients were treated with ZNS monotherapy (200-300 mg/day) for 8-12 weeks. After ZNS, MEP amplitudes decreased (-36.9%) significantly in epileptic hemispheres (paired t-test with Bonferroni’s correction for multiple comparisons, p<0.05), whereas the mean resting motor threshold, cortical silent period, short intracortical inhibition, and intracortical facilitation were unchanged (p>0.05). ZNS did not affect cortical excitability in nonepileptic hemispheres. Conclusions:These findings suggest that ZNS decreases cortical excitability only in the epileptic hemispheres of focal epilepsy patients. MEP amplitudes may be useful for evaluating ZNSinduced changes in cortical excitability.
Abstract
Background and Purpose:To evaluate changes in cortical excitability induced by zonisamide (ZNS) in focal epilepsy patients. Methods:Twenty-four drug-naїve focal epilepsy patients (15 males; overall mean age 29.8 years)were enrolled. The transcranial magnetic stimulation parameters obtained using two Magstim 200stimulators were the resting motor threshold, amplitude of the motor-evoked potential (MEP),cortical silent period, short intracortical inhibition, and intracortical facilitation. These five transcranial magnetic stimulation parameters were measured before and after ZNS, and the findings were compared. Results:All 24 patients were treated with ZNS monotherapy (200-300 mg/day) for 8-12 weeks. After ZNS, MEP amplitudes decreased (-36.9%) significantly in epileptic hemispheres (paired t-test with Bonferroni’s correction for multiple comparisons, p<0.05), whereas the mean resting motor threshold, cortical silent period, short intracortical inhibition, and intracortical facilitation were unchanged (p>0.05). ZNS did not affect cortical excitability in nonepileptic hemispheres. Conclusions:These findings suggest that ZNS decreases cortical excitability only in the epileptic hemispheres of focal epilepsy patients. MEP amplitudes may be useful for evaluating ZNSinduced changes in cortical excitability.
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