Motor cortical excitability in patients with poststroke epilepsy.
Motor cortical excitability in patients with poststroke epilepsy.
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脑卒中后癫痫患者运动皮质兴奋性。
DOI：
10.1111/j.1528-1167.2007.01231.x
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发表时间：
2008
期刊：
影响因子：
5.6
通讯作者：
Choi,Kyoung-Gyu
中科院分区：
文献类型：
--
作者：
Kim,JeeHyun;Lee,HyangWoon;Cohen,LeonardoG;Park,Kee-Duk;Choi,Kyoung-Gyu
目的：为了解脑卒中后癫痫（PSE）的发病机制，我们对18例慢性脑卒中患者（N = 18）和18例无PSE患者（N = 18）的运动皮层功能进行了评价。方法：我们测量了静息运动阈值（RMT）、运动诱发电位（MEP）幅度、皮层沉默期（CSP）、受GABA能神经传递影响的皮层内抑制（ICI）和受GABA能活动影响的皮层内易化（ICF）对经颅磁刺激的反应。结果：我们发现（1）PSE组患者的受累半球比未受累半球的MEP振幅和ICF更大，但在无癫痫患者中则没有，（2）在ICI无差异的情况下，RMT更高，CSP更长，H-反射或F-波在受累和未受累半球的PSE和non-PSE patients.Conclusions：增强皮质兴奋性，在受累半球，可能与增加海马神经元的活动，可能是一个机制，有助于中风后癫痫的发展。
Purpose:To gain insight into the mechanisms underlying poststroke epilepsy (PSE), we evaluated motor cortical function in chronic stroke patients with (N = 18) and without (N = 18) PSE.Methods:We measured resting motor threshold (RMT), motor evoked potential (MEP) amplitudes, cortical silent period (CSP), intracortical inhibition (ICI), influenced by GABAergic neurotransmission, and intracortical facilitation (ICF), influenced by glutamatergic activity, to transcranial magnetic stimulation.Results:We found (1) larger MEP amplitudes and ICF, in the affected than unaffected hemispheres of patients in the PSE group but not in patients without epilepsy, and (2) comparably higher RMT and longer CSP in the absence of differences in ICI, H‐reflexes or F‐waves in the affected and unaffected hemispheres of both PSE and non‐PSE patients.Conclusions:Enhanced cortical excitability in the affected hemisphere, possibly related to increased glutamatergic activity, could be one of the mechanisms contributing to the development of poststroke epilepsy.