Effect of levetiracetam on human corticospinal excitability

Sohn, Young H.; Kaelin‐Lang, Alain; Jung, Han Young; Hallett, Mark

doi:10.1212/wnl.57.5.858

Cited by 67 publications

(50 citation statements)

References 42 publications

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“…For example, F waves are often used in combination with transcranial magnetic stimulation to test whether excitability changes occur in the motor cortex or spinal cord. 5,28,35 This use of F waves for assessing motor neuron excitability is controversial, and H reflexes are usually superior for investigating the excitability of the motor pool. 11,14,18,21,24 However, F waves have the advantage of being easily obtained in a wider variety of muscles than H reflexes, and, in at least some studies, F waves and H reflexes exhibit similar changes.…”

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confidence: 99%

Do F‐wave measurements detect changes in motor neuron excitability?

Lin

Floeter

2004

Muscle and Nerve

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The use of F waves to assess motor neuron excitability in experimental paradigms has never been validated. Our objective was to determine whether F-wave area, amplitude, and persistence measurements change in response to manipulations known to alter the excitability of motor neurons. The effects of muscle vibration, contraction of a remote muscle, and high-intensity stimulation of ipsilateral or contralateral fingers were assessed in 12 healthy volunteers. F-wave area, amplitude, and persistence all declined with ipsilateral cutaneous stimulation. The other maneuvers facilitated some, but not all, of the F-wave measurements. Changes in F-wave area and amplitude were correlated, but neither correlated with changes in persistence. A sample size of 50-75 F waves was needed to approximate amplitude and area results from 100 F waves with an accuracy of +/- 25%. We conclude that changes in F waves are better at detecting inhibition than facilitation of motor neurons. F waves reflect motor neuron excitability in a general way but do not allow for accurate measures of short-term changes in excitability.

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confidence: 99%

Do F‐wave measurements detect changes in motor neuron excitability?

Lin

Floeter

2004

Muscle and Nerve

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“…When comparing all encephalitis patients with controls, we found significant differences in RMT which was not detectable in the subgroup without centrally active medication (including all drugs such as tiagabine, diazepam, lamotrigine, piracetam, gabapentin, topiramate, and levetiracetam). Even though there is somewhat conflicting data whether levetiracetam has large or subtle effects on single‐pulse TMS parameters,37, 38, 39 we conclude that the observed differences in RMT might partially depend on medication, while the observed PAS effect is most likely related to receptor changes attributable to NMDAR encephalitis. However, it is also possible that the subgroup without medication was too small to detect differences ( n = 11), and larger patient sizes are needed to confirm the influence of the medication.…”

Section: Discussionmentioning

confidence: 69%

Altered paired associative stimulation‐induced plasticity in NMDAR encephalitis

Volz

Finke

Harms

et al. 2016

Ann Clin Transl Neurol

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ObjectiveTo determine whether neurophysiological mechanisms indicating cortical excitability, long‐term potentiation (LTP)‐like plasticity, GABAergic and glutamatergic function are altered in patients with anti‐N‐methyl‐d‐aspartate receptor (NMDAR) encephalitis and whether they can be helpful as markers of diagnostic assessment, disease progression, and potentially therapy response.MethodsNeurophysiological characterizations of patients with NMDAR encephalitis (n = 34, mean age: 28 ± 11 years; 30 females) and age/gender‐matched healthy controls (n = 27, 28.5 ± 10 years; 25 females) were performed using transcranial magnetic stimulation‐derived protocols including resting motor threshold, recruitment curve, intracortical facilitation, short intracortical inhibition, and cortical silent period. Paired associative stimulation (PAS) was applied to assess LTP‐like mechanisms which are mediated through NMDAR. Moreover, resting state functional connectivity was determined using functional magnetic resonance imaging.Results PAS‐induced plasticity differed significantly between groups (P = 0.0056). Cortical excitability, as assessed via motor‐evoked potentials after PAS, decreased in patients, whereas it increased in controls indicating malfunctioning of NMDAR in encephalitis patients. Lower PAS‐induced plasticity significantly correlated with the modified Rankin Scale (mRS) (r = −0.41; P = 0.0031) and was correlated with lower functional connectivity within the motor network in NMDAR encephalitis patients (P < 0.001, uncorrected). Other neurophysiological parameters were not significantly different between groups. Follow‐up assessments were available in six patients and demonstrated parallel improvement of PAS‐induced plasticity and mRS.InterpretationAssessment of PAS‐induced plasticity may help to determine NMDAR dysfunction and disease severity in NMDAR encephalitis, and might even aid as a sensitive, noninvasive, and well‐tolerated “electrophysiological biomarker” to monitor therapy response in the future.Clinical Trial RegistrationClinicalTrials.gov: Identifier: NCT01865578

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“…49 While formal structured activities may be accurately captured using this method, incidental or unstructured physical activity may be missed, particularly as children typically engage in very short bursts of intensive physical activity interspersed with varying intervals of low to moderate activity. 50 Further testing of the validity and reliability of these subjective questionnaires for children with CP is required.…”

Section: Table Ofmentioning

confidence: 99%

Move it to improve it: using a web-based therapy program to increase physical activity in independently ambulant children and adolescents with unilateral cerebral palsy

Mitchell¹

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Background: Cerebral palsy (CP) is defined as a group of disorders of the development of movement and posture, causing activity limitations. Despite the known benefits of engaging in regular physical activity, children with cerebral palsy (CP) are less physically active than their typically developing peers. Active video games are gaining attention as a means of increasing physical activity in children with CP. 'Move it to improve it' or Mitii™ is a novel web-based multi-modal training program comprising upper-limb and visual perceptual training within the context of physical activity which uses virtual therapists to deliver an individualised therapy program. Should Mitii™ be effective in increasing physical activity it has the potential to reduce secondary health complications associated with physical inactivity. Aim:The primary aim of this doctoral program was to test the efficacy of Mitii™ to increase physical activity capacity and performance in independently ambulant children and adolescents with unilateral CP. Additional aims were to: i) determine the efficacy of virtual reality technologies to increase physical activity; ii) determine the clinimetric properties of measures of habitual physical activity; and iii) describe patterns of physical activity and characteristics associated with physical activity, in independently ambulant children and adolescents with CP. Research design and methodology:A matched pairs, waitlist controlled randomised trial was chosen to assess Mitii™ in independently ambulant children and adolescents aged eight to 17 years with unilateral CP. Participants (n=102) were allocated to receive 20 weeks of 6 days per week Mitii™ training (potential total dose 60 hours) immediately, or waitlisted receiving usual care. Outcomes were assessed at baseline and post-intervention (20 weeks). Physical activity capacity was recorded using functional strength (a series of maximal repetition exercises) and walking endurance (six-minute walk test); physical activity performance was recorded using ActiGraph ® tri-axial accelerometers. Secondary outcomes were mobility limitations (Mobility Questionnaire 28) and recreational participation (recreation domain of the Assessment of Life Habits).Results: Two systematic reviews were performed prior to commencement of the randomised trial. The first investigated the effect of virtual reality interventions to increase physical activity in children with CP. Included studies were of low methodological quality meaning few conclusions were able to be drawn, though there appeared to be a positive effect of virtual reality training. The second described the clinimetric properties of measures of physical activity in primary school aged children with CP. Accelerometers iii were found to be the most valid and clinically useful tool to measure physical activity however, evidence for their reliability in children with CP was lacking. This led to a study examining the reliability of measuring physical activity in children with unilateral CP using accelerometers. ...

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Effect of levetiracetam on human corticospinal excitability

Abstract: These results suggest that LTC reduces the corticospinal neuronal response to magnetic stimulation, preferentially affecting less excitable neurons. The lack of change in F-wave and CMAP suggests that this effect is mainly derived from the motor cortex.

Cited by 67 publications

References 42 publications

Do F‐wave measurements detect changes in motor neuron excitability?

Do F‐wave measurements detect changes in motor neuron excitability?

Altered paired associative stimulation‐induced plasticity in NMDAR encephalitis

Move it to improve it: using a web-based therapy program to increase physical activity in independently ambulant children and adolescents with unilateral cerebral palsy

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