Circadian variability of motor cortex excitability in patients with Mesial Temporal Lobe Epilepsy: a Transcranial Magnetic Stimulation (TMS) study

• Grant number: 19/10760-9
• Support Opportunities: Scholarships in Brazil - Doctorate
• Start date: September 01, 2019
• End date: August 31, 2022
• Field of knowledge: Health Sciences - Medicine
• Principal Investigator: Andre Russowsky Brunoni
• Grantee: Pedro Sudbrack Oliveira
• Host Institution: Instituto de Psiquiatria Doutor Antonio Carlos Pacheco e Silva (IPq). Hospital das Clínicas da Faculdade de Medicina da USP (HCFMUSP). Secretaria da Saúde (São Paulo - Estado). São Paulo , SP, Brazil

Abstract

Seizures in Mesial Temporal Lobe Epilepsy (MTLE) occur preferentially in the late afternoon period. These events arise due to imbalances between cortical excitatory and inhibitory activities, which can be indexed non-invasively with Transcranial Magnetic Stimulation (TMS). Objective: to assess motor cortex excitability in serial measurements over a 24-hour period using validated TMS paradigms, in patients with MTLE and controls. Hypotheses: patients will exhibit increased cortical excitability when compared to the control group, with greater differences in the late afternoon period. Methods: twenty non-operated adult patients with refractory MTLE without severe comorbidities and 20 healthy controls matched for age and gender will be evaluated at regular intervals of 4 hours over a 24-hour period using single and paired-pulse TMS - a validated, non-invasive method to index cortical excitability. The variables measured will be: motor threshold, motor evoked potential amplitude and latency, cortical silent period, short and long interval intracortical inhibition and intracortical facilitation. The patient group will be monitored using video-EEG in the same period and the rate of interictal epileptiform discharges and its daily distribution will be estimated. Conclusions: this proposal aims to better understand how motor cortex excitability is related to clinical outcomes (e.g. seizures) and whether time of the day is associated with those changes. This is important to unveil mechanisms associated with seizure onset and therefore to better individualize therapeutic interventions. (AU)

Scientific publications

(4)

(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)

RAZZA, LAIS B.; DE SMET, STEFANIE; MOFFA, ADRIANO; SUDBRACK-OLIVEIRA, PEDRO; VANDERHASSELT, MARIE-ANNE; BRUNONI, ANDRE R.. Follow-up effects of transcranial direct current stimulation (tDCS) for the major depressive episode: A systematic review and meta-analysis. PSYCHIATRY RESEARCH, v. 302, AUG 2021. (19/06009-6, 19/10760-9, 19/07256-7, 18/10861-7)

SUDBRACK-OLIVEIRA, PEDRO; RAZZA, LAIS B.; BRUNONI, ANDRE R.; MORO, E; POLOSAN, M; HAMANI, C. Non-invasive cortical stimulation: Transcranial direct current stimulation (tDCS). EMERGING HORIZONS IN NEUROMODULATION: NEW FRONTIERS IN BRAIN AND SPINE STIMULATION, v. 159, p. 22-pg., 2021-01-01. (19/10760-9, 19/07256-7)

SUDBRACK-OLIVEIRA, PEDRO; BARBOSA, MARINA ZANICHELLI; THOME-SOUZA, SIGRIDE; RAZZA, LAIS BORALLI; GALLUCCI-NETO, JOSE; LANE VALIENGO, LEANDRO DA COSTA; BRUNONI, ANDRE RUSSOWSKY. Transcranial direct current stimulation (tDCS) in the management of epilepsy: A systematic review. SEIZURE-EUROPEAN JOURNAL OF EPILEPSY, v. 86, p. 85-95, MAR 2021. (19/07256-7, 19/10760-9)

BAPTISTA, ABRAHAO FONTES; BALTAR, ADRIANA; OKANO, ALEXANDRE HIDEKI; MOREIRA, ALEXANDRE; CAMPOS, ANA CAROLINA PINHEIRO; FERNANDES, ANA MERCIA; BRUNONI, ANDRE RUSSOWSKY; BADRAN, BASHAR W.; TANAKA, CLARICE; DE ANDRADE, DANIEL CIAMPI; et al. Applications of Non-invasive Neuromodulation for the Management of Disorders Related to COVID-19. FRONTIERS IN NEUROLOGY, v. 11, NOV 25 2020. (19/10760-9, 18/18695-9)

Academic Publications

(References retrieved automatically from State of São Paulo Research Institutions)

OLIVEIRA, Pedro Sudbrack. Circadian characterization of motor cortical excitability in humans. 2022. Doctoral Thesis - Universidade de São Paulo (USP). Faculdade de Medicina (FM/SBD) São Paulo.