caa a22 4500 445807075 CHVBK 20180317145159.0 cr unu---uuuuu 170323e20110101xx s 000 0 eng 10.1007/s00415-010-5683-4 doi (NATIONALLICENCE)springer-10.1007/s00415-010-5683-4 Changes in interhemispheric inhibition following successful epilepsy surgery: a TMS study [Elektronische Daten] [C. Läppchen, B. Feil, S. Fauser, F. Glocker, A. Schulze-Bonhage] Epileptic foci can influence cortical excitability, brain perfusion and metabolism not only directly in the focus or perifocally, but also in remote areas. Effects of successful epilepsy surgery on cortical networks and changes in excitability have rarely been addressed. We report a study on changes in interhemispheric inhibition following successful surgical removal of an epileptic focus. Eighteen patients (11 females, 7 males, mean age 34.2years) were enrolled in this transcranial magnetic stimulation (TMS) study. All patients were seizure free after surgery and had identical antiepileptic medication pre- and postsurgically. Investigations were performed before and at least 3months after surgery. Motor thresholds (MT) and motor evoked potentials (MEPs) of interhemispheric paired pulse paradigms were investigated on both hemispheres. Resection of the epileptic focus resulted in a significant change in interhemispheric inhibition (IHI). The ability of the non-focal hemisphere to inhibit the motor cortex (M1) of the focal hemisphere significantly increased (p=0.02) and normalized to the level of the other hemisphere. In summary, this TMS study suggests that an epileptic focus can modulate interhemispheric inhibitory interactions between the motor cortices. A decreased susceptibility of M1 of the focal hemisphere or alterations in the non-focal hemispheric inhibitory output may be underlying mechanisms. These findings may contribute to a better understanding of widespread functional impairments in focal epilepsy. Springer-Verlag, 2010 Epilepsy nationallicence TMS nationallicence Transcranial magnetic stimulation nationallicence Epilepsy surgery nationallicence Inhibition nationallicence Läppchen C. Department of Neurology, University Medical Center, Freiburg, Germany aut Feil B. Department of Radiology, University Medical Center, Basel, Switzerland aut Fauser S. Epilepsy Center, University Medical Center, Freiburg, Germany aut Glocker F. Department of Neurology, University Medical Center, Freiburg, Germany aut Schulze-Bonhage A. Epilepsy Center, University Medical Center, Freiburg, Germany aut Journal of Neurology Springer-Verlag 258/1(2011-01-01), 68-73 0340-5354 258:1<68 2011 258 415 https://doi.org/10.1007/s00415-010-5683-4 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00415-010-5683-4 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Läppchen C. Department of Neurology, University Medical Center, Freiburg, Germany aut NATIONALLICENCE 700 1- Feil B. Department of Radiology, University Medical Center, Basel, Switzerland aut NATIONALLICENCE 700 1- Fauser S. Epilepsy Center, University Medical Center, Freiburg, Germany aut NATIONALLICENCE 700 1- Glocker F. Department of Neurology, University Medical Center, Freiburg, Germany aut NATIONALLICENCE 700 1- Schulze-Bonhage A. Epilepsy Center, University Medical Center, Freiburg, Germany aut NATIONALLICENCE 773 0- Journal of Neurology Springer-Verlag 258/1(2011-01-01), 68-73 0340-5354 258:1<68 2011 258 415 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer