期刊
SEIZURE-EUROPEAN JOURNAL OF EPILEPSY
卷 26, 期 -, 页码 36-42出版社
W B SAUNDERS CO LTD
DOI: 10.1016/j.seizure.2015.01.014
关键词
Transcranial magnetic stimulation; Epilepsy; Cortical excitability; GABA; Disinhibition
资金
- Neuromuscular Foundation of Western Australia
Purpose: Impaired GABAergic inhibition has been implicated in the pathophysiology of epilepsy. The possibility of a paradoxical excitatory effect of GABA in epilepsy has been suggested, but has not been investigated in vivo. We investigated pre- and post-synaptic GABAergic mechanisms in patients with idiopathic generalised epilepsy (IGE). Method: In 10 patients and 12 control subjects we explored short- and long-interval intracortical inhibition (SICI, LICI; post-synaptic GABA(A) and GABA(B)-mediated respectively) and long-interval intracortical facilitation (LICF; pre-synaptic disinhibition) using transcranial magnetic stimulation. Results: While post-synaptic GABAB-mediated inhibition was unchanged in IGE (p = 0.09), LICF was reduced compared to controls (controls: 141 +/- 17% of baseline; untreated patients: 107 +/- 12%, p = 0.2; treated patients: 79 +/- 10%, p = 0.003). GABA(A)-mediated inhibition was reduced in untreated patients (response amplitude 56 +/- 4% of baseline vs. 26 +/- 6% in controls, p = 0.004) and normalised with treatment (37 +/- 12%, p = 0.5 vs. controls). When measured during Lid, GABAA-mediated inhibition became excitatory in untreated IGE (response amplitude 120 10% of baseline, p = 0.017), but not in treated patients. Conclusion: Pre- and post-synaptic GABA-mediated inhibitory mechanisms are altered in IGE. The findings lend in vivo support to evidence from experimental models and in vitro studies of human epileptic brain tissue that GABA may have a paradoxical excitatory role in ictogenesis. (C) 2015 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据