The effect of lamotrigine and levetiracetam on TMS-evoked EEG responses depends on stimulation intensity

TY - JOUR

T1 - The effect of lamotrigine and levetiracetam on TMS-evoked EEG responses depends on stimulation intensity

AU - Premoli, Isabella

AU - Costantini, Alyssa

AU - Rivolta, Davide

AU - Biondi, Andrea

AU - Richardson, Mark P.

PY - 2017/10/20

Y1 - 2017/10/20

N2 - The combination of transcranial magnetic stimulation and electroencephalography (TMS-EEG) has uncovered underlying mechanisms of two anti-epileptic medications: levetiracetam and lamotrigine. Despite their different mechanism of action, both drugs modulated TMS-evoked EEG potentials (TEPs) in a similar way. Since both medications increase resting motor threshold (RMT), the current aim was to examine the similarities and differences in post-drug TEPs, depending on whether stimulation intensity was adjusted to take account of post-drug RMT increase. The experiment followed a placebo controlled, double blind, crossover design, involving a single dose of either lamotrigine or levetiracetam. When a drug-induced increase of RMT occurred, post-drug measurements involved two blocks of stimulations, using unadjusted and adjusted stimulation intensity. A cluster based permutation analysis of differences in TEP amplitude between adjusted and unadjusted stimulation intensity showed that lamotrigine induced a stronger modulation of the N45 TEP component compared to levetiracetam. Results highlight the impact of adjusting stimulation intensity.

AB - The combination of transcranial magnetic stimulation and electroencephalography (TMS-EEG) has uncovered underlying mechanisms of two anti-epileptic medications: levetiracetam and lamotrigine. Despite their different mechanism of action, both drugs modulated TMS-evoked EEG potentials (TEPs) in a similar way. Since both medications increase resting motor threshold (RMT), the current aim was to examine the similarities and differences in post-drug TEPs, depending on whether stimulation intensity was adjusted to take account of post-drug RMT increase. The experiment followed a placebo controlled, double blind, crossover design, involving a single dose of either lamotrigine or levetiracetam. When a drug-induced increase of RMT occurred, post-drug measurements involved two blocks of stimulations, using unadjusted and adjusted stimulation intensity. A cluster based permutation analysis of differences in TEP amplitude between adjusted and unadjusted stimulation intensity showed that lamotrigine induced a stronger modulation of the N45 TEP component compared to levetiracetam. Results highlight the impact of adjusting stimulation intensity.

KW - AED

KW - Electroencephalography

KW - Epilepsy

KW - Pharmaco-TMS-EEG

KW - Transcranial magnetic stimulation

UR - http://www.scopus.com/inward/record.url?scp=85032003160&partnerID=8YFLogxK

U2 - 10.3389/fnins.2017.00585

DO - 10.3389/fnins.2017.00585

M3 - Article

AN - SCOPUS:85032003160

SN - 1662-4548

VL - 11

JO - Frontiers in Neuroscience

JF - Frontiers in Neuroscience

IS - OCT

M1 - 585

ER -