Excitabilidad Cortical por Estimulación Magnética Transcraneal como Biomarcadores para el Control de las Convulsiones en Epilepsia del Lóbulo Temporal.: Publicado originalmente en la Revista Neuromodulation 2020; 23: 399–406.  Traducción: Dra. Luciana Caramuta.

Han-Wei Huang; Jing-Jane Tsai; Pei-Fang Su; Yu-Lin Mau; Yi-Jen Wu; Wen-Chi Wang; Chou-Ching K Lin

doi:10.47924/neurotarget202121

Autores/as

Han-Wei Huang Department of Neurology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Jing-Jane Tsai Department of Neurology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Pei-Fang Su Department of Statistics, College of Management, National Cheng Kung University, Tainan, Taiwan.
Yu-Lin Mau Department of Statistics, College of Management, National Cheng Kung University, Tainan, Taiwan.
Yi-Jen Wu Department of Neurology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Wen-Chi Wang Department of Neurology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Chou-Ching K. Lin Department of Neurology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan. https://orcid.org/0000-0002-3070-5787

DOI:

https://doi.org/10.47924/neurotarget202121

Palabras clave:

excitabilidad cortical, facilitación intracortical, inhibición intracortical de intervalo largo, inhibición intracortical de intervalo corto, epilepsia del lóbulo temporal, estimulación magnética transcraneal

Resumen

Objetivo: Investigar si los indicadores de excitabilidad cortical son buenos biomarcadores para el control de las convulsiones en epilepsia del lóbulo temporal (ELT).
Materiales y Métodos: Fueron reclutados tres grupos de sujetos: aquellos con pobre control (PC) ELT (N=41), buen control (WC) ELT (N=71), y controles sanos (N=44). Se obtuvieron curvas de recuperación de corta y larga latencia por pulsos pareados de estimulación magnética transcraneal. Se utilizaron modelos lineales de efectos mixtos para estudiar los efectos de agrupación, intervalo entre estímulos (IEE), y drogas antiepilépticas sobre inhibición intracortical de intervalo largo (LICI), inhibición intracortical de intervalo corto (SICI) y facilitación intracortical (ICF).
Resultados: El modelo de efectos mixtos que no incorporo drogas antiepilépticas mostro que la agrupación y el intervalo entre estímulos, fueron factores significativos para la inhibición intracortical de intervalo largo (LICI), de intervalo corto (SICI) y la facilitación intracortical (ICF). La inhibición intracortical de intervalo prolongado en el grupo de controles sanos fue mayor que en los dos grupos con epilepsia, y la diferencia fue significativa en el intervalo entre estímulos de 50, 150, y 200 mseg. En contraste, SICI/ICF en el grupo de pobre control fue mayor que en el grupo de controles sanos y el grupo de buen control, y la diferencia fue significativa en un intervalo entre estímulos de 15 mseg. Sin embargo, debido a la gran variabilidad fue difícil identificar un valor de corte con buena sensibilidad y especificidad. Con la incorporación de drogas antiepilépticas en el modelo de efectos mixtos no se obtuvieron cambios en los resultados.
Conclusiones: Aunque los parámetros de LICI y SICI/ICF fueron significativamente diferentes, estos pueden no ser los biomarcadores adecuados para el control de la epilepsia del lóbulo temporal.

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Murray CJ, Vos T, Lozano R et al. Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990–2010: a systematic analysis for the global burden of disease study 2010. Lancet 2012; 380:2197–2223.

Tellez-Zenteno JF, Hernandez-Ronquillo L. A review of the epidemiology of temporal lobe epilepsy. Epilepsy Res Treat 2012; 2012:630853.

Noachtar S, Remi J. The role of EEG in epilepsy: a critical review. Epilepsy Behav 2009; 15:22–33.

Hallett M. Transcranial magnetic stimulation: a primer. Neuron 2007; 55:187–199.

Ziemann U, Rothwell JC, Ridding MC. Interaction between intracortical inhibition and facilitation in human motor cortex. J Physiol 1996; 496:873–881.

Di Lazzaro V, Oliviero A, Meglio M et al. Direct demonstration of the effect of lorazepam on the excitability of the human motor cortex. Clin Neurophysiol 2000; 111:794–799.

Werhahn KJ, Kunesch E, Noachtar S, Benecke R, Classen J. Differential effects on motorcortical inhibition induced by blockade of GABA uptake in humans. J Physiol 1999; 517:591–597.

Badawy RA, Macdonell RA, Berkovic SF, Newton MR, Jackson GD. Predicting seizure control: cortical excitability and antiepileptic medication. Ann Neurol 2010; 67:64–73.

Badawy RA, Vogrin SJ, Lai A, Cook MJ. The cortical excitability profile of temporal lobe epilepsy. Epilepsia 2013; 54:1942–1949.

Bauer PR, de Goede AA, Stern WM et al. Longinterval intracortical inhibition as biomarker for epilepsy: a transcranial magnetic stimulation study. Brain 2018; 141:409–421.

Hamer HM, Reis J, Mueller HH et al. Motor cortex excitability in focal epilepsies not including the primary motor area—a TMS study. Brain 2005; 128:811–818.

Pawley AD, Chowdhury FA, Tangwiriyasakul C et al. Cortical excitability correlates with seizure control and epilepsy duration in chronic epilepsy. Ann Clin Transl Neurol 2017; 4:87–97.

Tataroglu C, Ozkiziltan S, Baklan B. Motor cortical thresholds and cortical silent periods in epilepsy. Seizure 2004; 13:481–485.

Badawy RA, Curatolo JM, Newton M, Berkovic SF, Macdonell RA. Changes in cortical excitability differentiate generalized and focal epilepsy. Ann Neurol 2007; 61:324–331.

Werhahn KJ, Lieber J, Classen J, Noachtar S. Motor cortex excitability in patients with focal epilepsy. Epilepsy Res 2000; 41:179–189.

Cantello R, Civardi C, Cavalli A et al. Cortical excitability in cryptogenic localization-related epilepsy: Interictal transcranial magnetic stimulation studies. Epilepsia 2000; 41:694–704.

Wright MA, Orth M, Patsalos PN, Smith SJ, Richardson MP. Cortical excitability predicts seizures in acutely drug-reduced temporal lobe epilepsy patients. Neurology 2006; 67:1646–1651. 18- Ziemann U. TMS and drugs. Clin Neurophysiol 2004; 115:1717–1729.

Ziemann U. Pharmaco-transcranial magnetic stimulation studies of motor excitability. Handb Clin Neurol 2013; 116:387–397.

Kirschner J, Moll GH, Fietzek UM et al. Methylphenidate enhances both intracortical inhibition and facilitation in healthy adults. Pharmacopsychiatry 2003;36: 79–82.

Lee HW, Seo HJ, Cohen LG, Bagic A, Theodore WH. Cortical excitability during prolonged antiepileptic drug treatment and drug withdrawal. Clin Neurophysiol 2005; 116:1105–1112.

Ertas NK, Gul G, Altunhalka A, Kirbas D. Cortical silent period following transcranial magnetic stimulation in epileptic patients. Epileptic Disord 2000;2: 137–140.

Hermsen AM, Haag A, Duddek C et al. Test–retest reliability of single and paired pulse transcranial magnetic stimulation parameters in healthy subjects. J Neurol Sci 2016; 362:209–216.

Bolden LB, Griffis JC, Pati S, Szaflarski JP. Cortical excitability and neuropsychological functioning in healthy adults. Neuropsychologia 2017; 102:190–196.

Vallence AM, Smalley E, Drummond PD, Hammond GR. Long-interval intracortical inhibition is asymmetric in young but not older adults. J Neurophysiol 2017;118: 1581–1590.

Hattemer K, Knake S, Reis J et al. Excitability of the motor cortex during ovulatory and anovulatory cycles: A transcranial magnetic stimulation study. Clin Endocrinol 2007; 66:387–393.

Pellicciari MC, Miniussi C, Ferrari C, Koch G, Bortoletto M. Ongoing cumulative effects of single TMS pulses on corticospinal excitability: An intra- and inter-block investigation. Clin Neurophysiol 2016; 127:621–628.

Vaseghi B, Zoghi M, Jaberzadeh S. Inter-pulse interval affects the size of singlepulse TMS-induced motor evoked potentials: A reliability study. Basic Clin Neurosci 2015; 6:44–51.

Fleming MK, Sorinola IO, Newham DJ, RobertsLewis SF, Bergmann JH. The effect of coil type and navigation on the reliability of transcranial magnetic stimulation. IEEE Trans Neural Syst Rehabil Eng 2012; 20:617–625.

Valzania F, Quatrale R, Strafella AP et al. Pattern of motor evoked response to repetitive transcranial magnetic stimulation. Electroencephalogr Clin Neurophysiol. 1994; 93:312–317.

Kwan P, Arzimanoglou A, Berg AT et al. Definition of drug resistant epilepsy: Consensus proposal by the ad hoc task force of the ILAE commission on therapeutic strategies. Epilepsia 2010; 51:1069–1077.

Groppa S, Oliviero A, Eisen A et al. A practical guide to diagnostic transcranial magnetic stimulation: Report of an IFCN committee. Clin Neurophysiol 2012; 123:858–882.

Joo EY, Kim SH, Seo DW, Hong SB. Zonisamide decreases cortical excitability in patients with idiopathic generalized epilepsy. Clin Neurophysiol 2008; 119:1385–1392.

De Goede AA, Ter Braack EM, van Putten M. Single and paired pulse transcranial magnetic stimulation in drug naive epilepsy. Clin Neurophysiol 2016; 127: 3140–3155.

Silbert BI, Heaton AE, Cash RF et al. Evidence for an excitatory GABAA response in human motor cortex in idiopathic generalised epilepsy. Seizure. 2015; 26:36– 42.

Stern WM, Sander JW, Rothwell JC, Sisodiya SM. Impaired intracortical inhibition demonstrated in vivo in people with Dravet syndrome. Neurology 2017; 88:1659–1665.

Brodtmann A, Macdonell RA, Gilligan AK, Curatolo J, Berkovic SF. Cortical excitability and recovery curve analysis in generalized epilepsy. Neurology 1999; 53:1347–1349.

Sommer M, Gileles E, Knappmeyer K, Rothkegel H, Polania R, Paulus W. Carbamazepine reduces shortinterval interhemispheric inhibition in healthy humans. Clin Neurophysiol 2012; 123:351–357.

Granger P, Biton B, Faure C et al. Modulation of the gamma-aminobutyric acid type A receptor by the antiepileptic drugs carbamazepine and phenytoin. Mol Pharmacol 1995; 47:1189–1196.