Changes in amygdala, cerebellum, and nucleus accumbens volumes in bipolar patients treated with lamotrigine

Bauer, Isabelle E.; Suchting, Robert; Cazala, Fadwa; Alpak, Gökay; Sanches, Marsal; Nery, Fabiano G.; Zunta-Soares, Giovana; Soares, Jair C.

doi:10.1016/j.pscychresns.2018.06.005

Cited by 10 publications

(10 citation statements)

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“…In the present study, we considered a PP ≥ 75% that an effect of treatment exists worthy of further investigation; disparate researchers can and should consider their own subjective probability threshold that an effect exists. We chose this value for its (a) consistency with previous work using these data (Ahn et al, 2018), (b) similarity to thresholds researchers chose in other recent trials investigating treatment effects (Bauer et al, 2018; Cazala et al, 2018; Schmitz et al, 2017), and (c) correspondence with the scientific and clinical opinion of the present research team that the current research would be worthy of further investigation if there was at least a 3 in 4 chance that the alternative hypothesis was correct. For further justification of the use of Bayesian inference in the present study (including a brief discussion of frequentist vs. Bayesian inference), see a previous inspection of these data regarding the effects of tDCS on experimental pain measures (Ahn et al, 2018).…”

Section: Methodsmentioning

confidence: 92%

The Effect of Transcranial Direct Current Stimulation on Inflammation in Older Adults With Knee Osteoarthritis: A Bayesian Residual Change Analysis

Suchting

Colpo

Rocha

et al. 2019

Biological Research For Nursing

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Transcranial direct current stimulation (tDCS) has demonstrated effectiveness in reducing clinical and experimental measures of pain in patients with chronic pain; however, research examining the mechanisms of action for the effects of tDCS has been lacking. The present study investigated the effect of active tDCS on measures of inflammation and stress. Older adults (aged 50–70 years) with knee osteoarthritis (OA) were randomly assigned to receive daily 20-min sessions of either tDCS ( n = 20) or sham tDCS ( n = 20) for 5 consecutive days. Participants provided blood samples at baseline and the end of treatment. The following measures of immune function and stress were collected: interleukin (IL)-6 and 10, tumor necrosis factor-α (TNF-α), C-reactive protein, cortisol, and β-endorphin. Generalized linear modeling evaluated each posttreatment measure as a function of tDCS group, controlling for baseline (measuring residual change, analogous to analysis of covariance). Bayesian statistical inference was used to directly quantify the probability of the effect of active tDCS. IL-6, IL-10, TNF-α, and β-endorphin demonstrated lower levels of stress and inflammation in the active tDCS group. These findings provide preliminary evidence that active (relative to sham) tDCS is associated with reduced levels of inflammation.

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Section: Methodsmentioning

confidence: 92%

The Effect of Transcranial Direct Current Stimulation on Inflammation in Older Adults With Knee Osteoarthritis: A Bayesian Residual Change Analysis

Suchting

Colpo

Rocha

et al. 2019

Biological Research For Nursing

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“…This threshold was chosen for consistency with previous work using data collected during this trial, 9,10 as well as similarity to thresholds that researchers chose in other recent trials investigating treatment effects. 35,36 Bayesian analyses provide findings that may be directly compared with previous findings in this research area that used frequentist analyses. As in the frequentist approach, Bayesian methods provide a point estimate and a credible range of values for model effects; the difference here is that the values are more probabiliistically intuitive than those derived by frequentist methods.…”

Section: Data Analytic Strategymentioning

confidence: 93%

“…In the view of the present research team, PP=75% provided the minimum threshold of interest to consider effects to be potentially worthy of future investigation. This threshold was chosen for consistency with previous work using data collected during this trial,9,10 as well as similarity to thresholds that researchers chose in other recent trials investigating treatment effects 35,36…”

Section: Methodsmentioning

confidence: 99%

Changes in Brain-derived Neurotrophic Factor From Active and Sham Transcranial Direct Current Stimulation in Older Adults With Knee Osteoarthritis

Suchting

Teixeira

Ahn

et al. 2021

The Clinical Journal of Pain

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Objectives: Previous work has shown effects of transcranial direct current stimulation (tDCS) on clinical pain measures, qualitative sensory testing measures, and peripheral inflammation. The present report extends this research to investigate the effect of tDCS on brain-derived neurotrophic factor (BDNF) levels.Materials and Methods: This secondary analysis examined a sample of 40 older adults (50 to 70 y old) with symptomatic knee osteoarthritis randomly assigned in a 1:1 fashion to active (n = 20) or sham (n = 20) tDCS for 20 minutes on 5 consecutive days. BDNF was measured before the first session and after the final treatment session. Generalized linear modeling evaluated BDNF plasma levels as a function of tDCS group, adjusted for baseline. Bayesian statistical inference was used to quantify the probability that effects of the treatment exist.Results: Generalized linear modeling indicated a 90.4% posterior probability that the sham condition had 49.9% higher BDNF at the end of treatment, controlling for baseline. Follow-up analyses within the active TDCS group supported an association between change in BDNF and change in clinical pain, and exploratory analyses found an effect of tDCS on irisin.Discussion: Results indicated that tDCS could be a potential nonpharmacological treatment to decrease BDNF levels, which may in turn decrease pain. This study adds to a growing literature suggesting that tDCS affects cortical excitability, and consequentially, the neural circuits implicated in pain modulation. In addition to a direct connection to analgesia, BDNF changes may reflect tDCSinduced changes in different cortical areas and/or neural circuits.

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“…However, there is some evidence that LTG might be associated with cerebellar volume loss. Patients with bipolar depression treated with 200 mg/day LTG for 12 weeks, showed volume reduction in the cerebellum, amygdala and nucleus accumbens, but only those who clinically responded to the treatment (Bauer et al 2018). It is unknown why some patients exhibited cerebellar volume loss, some others did not.…”

Section: Recording Positionmentioning

confidence: 99%

“…Alternative mechanisms of drug induced tremor also cannot be excluded. A recent report showed that in patients with bipolar disorder after 12-week of lamotrigine monotherapy the volume of the cerebellum decreased (Bauer et al 2018). Cerebellar signs and symptoms, like ataxia, nystagmus, vertigo, as LTG side-effects were also noted in epilepsy patients (Moreira et al 2007;Thome-Souza et al 2012).…”

Section: Introductionmentioning

confidence: 96%

Lamotrigine Induces Tremor among Epilepsy Patients Probably via Cerebellar Pathways

Kovács

Farkas

Kelemen

et al. 2019

Tohoku J. Exp. Med.

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Lamotrigine, a frequently used antiepileptic drug, inhibits voltage-gated sodium-channels. By suppressing the release of glutamate and aspartate, lamotrigine acts as a membrane stabilizer, and it is also effective in bipolar disorder and migraine. However, lamotrigine is known to induce tremor among 4-10% of patients. We examined the lamotrigine-induced tremor in 28 epilepsy patients (age: 38.06 ± 13.56 years; 24 females and 4 males) receiving lamotrigine monotherapy and compared the data to 30 age-and sex-matched controls (age: 33.06 ± 10.71 years; 25 females and 5 males). Tremor was visually assessed by clinical tremor rating scales. Quantitative characteristics (intensity, center frequency and frequency dispersion) which are regularly used to differentiate various tremor syndromes were measured by validated, sensitive biaxial accelerometry in resting, postural and intentional positions. Regularity of repetitive finger and hand movements and reaction time were also determined. Data were statistically analyzed. Clinical tremor rating scales detected pathological tremor in three patients (10%), while accelerometry revealed tremor in seven patients (25%). Center frequency of patients with pathological tremor was similar to controls, but the frequency dispersion was significantly lower and tremor intensity was significantly higher in both postural and intentional positions. Rhythmic movements and reaction time were normal. Our results show that objective measurements detect pathological intention tremor in 25% of epilepsy patients receiving lamotrigine monotherapy. Quantitative characteristics suggest the involvement of the cerebellum in the pathomechanism of lamotrigine-induced tremor. Determining the parameters of drug-induced tremor syndromes might help to understand the complex action of tremor generator networks.

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Changes in amygdala, cerebellum, and nucleus accumbens volumes in bipolar patients treated with lamotrigine

Cited by 10 publications

References 75 publications

The Effect of Transcranial Direct Current Stimulation on Inflammation in Older Adults With Knee Osteoarthritis: A Bayesian Residual Change Analysis

The Effect of Transcranial Direct Current Stimulation on Inflammation in Older Adults With Knee Osteoarthritis: A Bayesian Residual Change Analysis

Changes in Brain-derived Neurotrophic Factor From Active and Sham Transcranial Direct Current Stimulation in Older Adults With Knee Osteoarthritis

Lamotrigine Induces Tremor among Epilepsy Patients Probably via Cerebellar Pathways

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