Zonisamide changes unilateral cortical excitability in focal epilepsy patients.
OBJECTIVE
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 200 stimulators 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 ZNS-induced changes in cortical excitability.
Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Eun Yeon
EY
Joo
Hye-Jung
HJ
Kim
Yang-Hee
YH
Lim
Ki-Hwan
KH
Ji
Seung Bong
SB
Hong
Lancet. 1992 Feb 8;339(8789):362-3
1346432
Brain Dev. 1998 Mar;20(2):75-9
9545175
Ann Neurol. 1996 Sep;40(3):367-78
8797526
J Neurol Neurosurg Psychiatry. 2001 Dec;71(6):772-6
11723199
Seizure. 2004 Dec;13 Suppl 1:S5-9; discussion S10
15511691
Exp Brain Res. 2004 Feb;154(4):488-93
14579005
Epilepsy Res. 1992 Jun;12(1):21-7
1326433
Seizure. 1996 Jun;5(2):115-9
8795126
Epilepsia. 1994 Jan-Feb;35(1):53-60
8112258
Neurology. 1998 Nov;51(5):1320-4
9818853
Exp Brain Res. 1996 Apr;109(1):127-35
8740215
Epilepsia. 1995 Jul;36(7):644-8
7555979
Pol J Pharmacol. 2003 Sep-Oct;55(5):683-9
14704463
Clin Neurophysiol. 2000 Jun;111(6):964-74
10825702
Neuron. 2001 Jul 19;31(1):35-45
11498049
Neuroimage. 2005 Jan 1;24(1):101-10
15588601
Clin Neurophysiol. 2005 May;116(5):1105-12
15826851
Epilepsia. 2004 Jun;45(6):610-7
15144425
J Clin Neurol. 2007 Dec;3(4):175-80
19513128
Epilepsy Res. 2000 Sep;41(2):179-89
10940619
Neurology. 1997 Sep;49(3):881-3
9305361
J Physiol. 1996 Nov 1;496 ( Pt 3):873-81
8930851
Can J Neurol Sci. 2001 Nov;28(4):341-5
11766778
Neurology. 2001 Aug 28;57(4):706-8
11524485
Brain. 2005 Aug;128(Pt 8):1802-10
15872014
Epileptic Disord. 2009 Mar;11(1):61-6
19264587
Neurology. 2001 Sep 11;57(5):858-63
11552017
Ann Neurol. 2007 Apr;61(4):324-31
17358004
Epilepsia. 1999 Mar;40(3):316-21
10080512
Arzneimittelforschung. 1982;32(12):1581-6
6891599
Exp Brain Res. 1999 Feb;124(4):447-54
10090656
Brain. 2000 Oct;123 ( Pt 10):2150-9
11004131
Epilepsy Behav. 2004 Dec;5(6):1024-6
15582856
J Physiol. 1993 Nov;471:501-19
8120818
Clin Neurophysiol. 2008 Jun;119(6):1385-92
18396455
Epilepsia. 2002 Oct;43(10):1149-56
12366728
Neurology. 2001 Nov 27;57(10):1774-9
11723262
Epilepsia. 2005 Jan;46(1):31-41
15660766
Ann Neurol. 1993 Sep;34(3):351-5
8363351