Effects of immunotherapy on motor cortex excitability in Stiff Person Syndrome.
A number of cortical and spinal excitability variables have been tested in a patient with Stiff Person Syndrome (SPS), before and after immunotherapy with mycophenolate mofetil, intravenous immunoglobulin and corticosteroids, which normalized plasma levels of anti-GAD antibodies and dramatically improved the clinical picture. The overlapping time-course of neurophysiological, clinical and bio-umoral findings suggests that immunotherapy might have changed GABA/Glutamate balance at cortical level, favoring the former, as reflected by normalization of the startle reflex, lengthening of the cortical silent period and clear-cut reduction of intracortical facilitation to paired-pulse transcranial magnetic stimulation. This represents the first report investigating effects of immunotherapy on cortical excitability in SPS.
Rossi
Simone
S
Dipartimento di Neuroscienze, Sezione Neurologia, University of Siena, Policlinico Le Scotte, Viale Bracci, 53100, Siena, Italy. Rossisimo@unisi.it
Ulivelli
Monica
M
Malentacchi
Maria
M
Greco
Giuseppe
G
Bartalini
Sabina
S
Borgogni
Patrizia
P
Giannini
Fabio
F
D000328:Adult; D004576:Electromyography; D019054:Evoked Potentials, Motor / Q000187:drug effects; D005260:Female; D006801:Humans; D007167:Immunotherapy; D009044:Motor Cortex / Q000187:drug effects / Q000503:physiopathology*; D009433:Neural Inhibition / Q000187:drug effects; D013216:Reflex, Startle / Q000187:drug effects; D016750:Stiff-Person Syndrome / Q000188:drug therapy / Q000503:physiopathology* / Q000628:therapy*; D013997:Time Factors; D050781:Transcranial Magnetic Stimulation; D016896:Treatment Outcome