Pharmacologic reversal of cortical hyperexcitability in patients with ALS

M. Donatella Caramia, M. Giuseppina Palmieri, M. T. Desiato, C. Iani, A. Scalise, S. Telera, G. Bernardi

Research output: Contribution to journalArticle

57 Citations (Scopus)

Abstract

Objective: To reverse the profile of abnormal intracortical excitability in patients with ALS by administering drugs that promote GABAergic transmission. Background: Transcranial magnetic stimulation (TMS) has revealed abnormalities of cortical inhibition in ALS, a reduction of the silent period, and the absence of intracortical inhibition normally occurring in response to paired TMS. Impaired inhibitory transmission could play a role in the physiopathology of this illness. Methods: Using paired TMS with conditioning stimuli from 1-to-6-msec-interstimulus intervals, we investigated 16 patients with ALS. The protocol included: (1) the 'drug-free' profile of paired TMS; (2) paired TMS 30 minutes after the intake of diazepam (3.5 mg); (3) paired TMS after 3 weeks' treatment with gabapentin (GBP) (600 mg/day) or riluzole (50 mg/twice a day). Results: Intracortical inhibition is lost in patients with ALS, and this abnormal profile is reversed by diazepam or sustained treatment with GBP. We also noted that motor-evoked potential amplitudes to single stimuli increased (p <0.01) after diazepam and GBP. Conclusions: The demonstration of pharmacologic reversal of hyperexcitability in patients with ALS makes a potentially significant contribution toward understanding the pathophysiology of a disease that has so far eluded an effective cure.

Original languageEnglish
Pages (from-to)58-64
Number of pages7
JournalNeurology
Volume54
Issue number1
Publication statusPublished - Jan 11 2000

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Transcranial Magnetic Stimulation
Diazepam
Riluzole
Motor Evoked Potentials
Pharmaceutical Preparations
Therapeutics
gabapentin

Keywords

  • ALS
  • GABAergic drugs
  • Intracortical inhibition
  • Motor evoked potential
  • Paired transcranial magnetic stimulation

ASJC Scopus subject areas

  • Neuroscience(all)

Cite this

Donatella Caramia, M., Giuseppina Palmieri, M., Desiato, M. T., Iani, C., Scalise, A., Telera, S., & Bernardi, G. (2000). Pharmacologic reversal of cortical hyperexcitability in patients with ALS. Neurology, 54(1), 58-64.

Pharmacologic reversal of cortical hyperexcitability in patients with ALS. / Donatella Caramia, M.; Giuseppina Palmieri, M.; Desiato, M. T.; Iani, C.; Scalise, A.; Telera, S.; Bernardi, G.

In: Neurology, Vol. 54, No. 1, 11.01.2000, p. 58-64.

Research output: Contribution to journalArticle

Donatella Caramia, M, Giuseppina Palmieri, M, Desiato, MT, Iani, C, Scalise, A, Telera, S & Bernardi, G 2000, 'Pharmacologic reversal of cortical hyperexcitability in patients with ALS', Neurology, vol. 54, no. 1, pp. 58-64.
Donatella Caramia M, Giuseppina Palmieri M, Desiato MT, Iani C, Scalise A, Telera S et al. Pharmacologic reversal of cortical hyperexcitability in patients with ALS. Neurology. 2000 Jan 11;54(1):58-64.
Donatella Caramia, M. ; Giuseppina Palmieri, M. ; Desiato, M. T. ; Iani, C. ; Scalise, A. ; Telera, S. ; Bernardi, G. / Pharmacologic reversal of cortical hyperexcitability in patients with ALS. In: Neurology. 2000 ; Vol. 54, No. 1. pp. 58-64.
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