Expression of praxis induction on cortical excitability in juvenile myoclonic epilepsy

Expression of praxis induction on cortical excitability in juvenile myoclonic epilepsy

Author Vidal-Dourado, Marcos Autor UNIFESP Google Scholar
Nunes, Karlo Faria Autor UNIFESP Google Scholar
Bittar Guaranha, Mirian Salvadori Autor UNIFESP Google Scholar
Pereira Giuliano, Lydia Maria Autor UNIFESP Google Scholar
Targas Yacubian, Elza Marcia Autor UNIFESP Google Scholar
Manzano, Gilberto Mastrocola Autor UNIFESP Google Scholar
Abstract Objective: This study aimed to evaluate the effects of praxis induction on sensorimotor cortical and transcallosal excitability in juvenile myoclonic epilepsy (JME). Methods: A total of 36 subjects (18-62 years) were included. The JME group was screened by video-electroencephalography neuropsychological protocol and divided into JME without praxis induction [JME-WI (n = 12)], JME with praxis-induced seizures or epileptiform discharges [JME-PI (n = 10)], and healthy controls (n = 14). Motor and somatosensory cortical excitability and transcallosal pathways were evaluated through single-pulse transcranial magnetic stimulation (sTMS) and somatosensory evoked potentials (SEPs). Results: Motor and transcallosal excitabilities tested with sTMS were not different in the motor-dominant or non-dominant hemisphere among groups. Significant differences were found in cortical SEP amplitudes in the P27 component of the non-dominant hemisphere (p = 0.03, Cohen's d = 0.98), N35 in the dominant hemisphere (p = 0.04, Cohen's d = 0.96), and P27-35 interpeak amplitude in both somatosensory cortices of the JME-PI group (p = 0.03, Cohen's d = 0.96

p = 0.02, Cohen's d = 1.05) when compared with healthy controls. Giant SEPs were observed in two (16.7%) and five (50%) patients of the JME-WI and JME-PI groups, respectively. Cortical latencies did not reveal differences. Conclusions: Praxis induction was associated with enhanced excitability in the somatosensory cortex of JME patients. Significance: These findings may help clarifying the less favorable therapeutic response in the JME-PI group and indicate identifying praxis induction as an important determinant in differentiating between JME patients. (C) 2016 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.
Keywords Transcallosal excitability
Idiopathic generalized epilepsy
Reflex epilepsies
Somatosensory evoked potential
Transcranial magnetic stimulation
xmlui.dri2xhtml.METS-1.0.item-coverage Clare
Language English
Sponsor FAPESP, Sao Paulo, Brazil
Date 2016
Published in Clinical Neurophysiology. Clare, v. 127, n. 7, p. 2551-2560, 2016.
ISSN 1388-2457 (Sherpa/Romeo, impact factor)
Publisher Elsevier Ireland Ltd
Extent 2551-2560
Access rights Closed access
Type Article
Web of Science ID WOS:000377988900002

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