The Study Of Cortical Excitability In Epileptic Patients By Transcranial Magnetic Stimulation

Objective: Transcranial magnetic stimulation(TMS)was used to investigate the excitability of cerebral cortex in patients with different types of epilepsy.To further understand the influencing factors of cortical excitability in epileptic patients.Methods: According to the classification standard of 2017 international anti epileptic alliance,epileptic patients who were hospitalized in the outpatient department of Neurology of Affiliated Hospital of Qingdao University and agreed to participate in the study were divided into four groups according to whether they took antiepileptic drugs or not.They were divided into four groups: focal epilepsy without medication(FE-AED),focal epilepsy with medication(FE+AED),general epilepsy without medication(GEAED)and general epilepsy with medication(GE+AED).Healthy people without nervous system organ and functional disorder were selected as the normal control group.The resting motor threshold(RMT),amplitude of motor evoked potential(MEP-A)and latency of motor evoked potential(MEP-L)were measured by transcranial magnetic stimulation and recorded as the original data.RMT,MEP-A and MEP-L were compared in each group.The analysis of variance of repeated measurement was used to compare the two groups,and the least significant difference t-test was used to compare the two groups.Results: In this study,14 patients in focal epilepsy without medication(FE-AED),17 in focal epilepsy with medication(FE+AED),13 in general epilepsy without medication(GE-AED),8 in general epilepsy with medication(GE+AED)and 15 in the healthy control group were collected.The statistical results showed that there was no significant difference in RMT,MEP-A and MEP-L between these groups(PRMT=0.091,PMEPA=0.073,PMEP-L=0.284),but there was significant difference in RMT and MEP-A between the different groups(PRMT = 0.091,PMEP-A = 0.073).On this basis,the data between different groups were compared.Among them,there was a significant difference(P = 0.044)between the rest movement threshold of FE-AED(RMT = 35.36 ± 7.96%)and FE+AED(RMT = 45.59 ± 14.13%).There was a significant difference(P = 0.021)between the MEP-A in FE-AED(105.21 ± 26.28 ? V)and the normal control group (88.27 ± 14.29 ? V).The difference between the MEP-A of FE+AED(103.94±18.73?V)and the normal control group(88.27±14.29?V)was statistically significant(P = 0.01);the difference of RMT between the two groups was also statistically significant(P = 0.044):FE-AED and GE+AED;there was no significant difference between the other groups(P > 0.05).However,there are still two groups in which the test statistic P is in a critical state,and the difference may be statistically significant,which are: RMT comparison between the GE-AED group and the GE+AED(P = 0.052);MEP-A level statistical comparison between the GE-AED group and the normal group(P = 0.064).Conclusion: The level of cortical excitability of patients with focal epilepsy was significantly higher than that of normal people,and the level of cortical excitability of patients with focal epilepsy could be significantly inhibited by antiepileptic drugs.The significant difference between patients without focal epilepsy and patients with comprehensive epilepsy suggested that epilepsy type and antiepileptic drugs may have an impact on cortical excitability.The comparison of cortical excitability between the general epilepsy group and the normal control group,the comprehensive epilepsy group and the non medication group needs to be further verified by expanding the sample size.