title: Zonisamide decreases cortical excitability in patients with idiopathic generalized epilepsy.
abstract: OBJECTIVE
  To evaluate changes in cortical excitability after long-term zonisamide (ZNS) administration.
  
  
  METHODS
  Fifteen drug-naïve idiopathic generalized epilepsy (IGE) patients (8 male, mean age 24.9 years) were enrolled. The transcranial magnetic stimulation (TMS) parameters obtained using two Magstim 200 stimulators were resting motor threshold (RMT), motor evoked potential (MEP) amplitudes, cortical silent period (CSP), intracortical inhibition (ICI), and intracortical facilitation (ICF). TMS parameters were compared before and after ZNS administration.
  
  
  RESULTS
  All patients were administered ZNS monotherapy (200 mg/day) for 8 weeks. No patient reported seizures during the study period. After ZNS treatment MEP amplitudes were significantly reduced in right (-34.2%) and left hemispheres (-37.0%) (Wilcoxon's signed rank test after Bonferroni's correction for multiple comparisons, P < 0.05). Mean RMT, CSP, and ICI/ICF were not changed by ZNS (P > 0.05).
  
  
  CONCLUSIONS
  These findings suggest that ZNS decreases cortical excitability in patients with IGE and a MEP amplitude is a useful TMS parameter for evaluating changes in cortical excitability induced by ZNS.
  
  
  CONCLUSIONS
  The findings in this study are helpful to understand how ZNS affects the excitability of the motor cortex in patients with IGE.
authors.affiliation: Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, Seoul 135-710, Republic of Korea.
authors.forename: Eun Yeon
authors.initials: EY
authors.lastname: Joo
authors.forename: Sun Hwa
authors.initials: SH
authors.lastname: Kim
authors.forename: Dae Won
authors.initials: DW
authors.lastname: Seo
authors.forename: Seung Bong
authors.initials: SB
authors.lastname: Hong
mesh_terms: D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use*; D004558:Electric Stimulation / Q000379:methods; D004829:Epilepsy, Generalized / Q000188:drug therapy*; D019054:Evoked Potentials, Motor / Q000187:drug effects* / Q000528:radiation effects; D005260:Female; D007839:Functional Laterality; D006801:Humans; D007555:Isoxazoles / Q000627:therapeutic use*; D008297:Male; D009044:Motor Cortex / Q000187:drug effects* / Q000503:physiopathology / Q000528:radiation effects; D009433:Neural Inhibition; D018709:Statistics, Nonparametric; D050781:Transcranial Magnetic Stimulation; D000078305:Zonisamide
chemical_list: D000927:Anticonvulsants; D007555:Isoxazoles; D000078305:Zonisamide