Effects of immunotherapy on motor cortex excitability in Stiff Person Syndrome.

Abstract

A number of cortical and spinal excitability variables have been tested in a patient with Stiff Person Syndrome (SPS), before and after immunotherapy with mycophenolate mofetil, intravenous immunoglobulin and corticosteroids, which normalized plasma levels of anti-GAD antibodies and dramatically improved the clinical picture. The overlapping time-course of neurophysiological, clinical and bio-umoral findings suggests that immunotherapy might have changed GABA/Glutamate balance at cortical level, favoring the former, as reflected by normalization of the startle reflex, lengthening of the cortical silent period and clear-cut reduction of intracortical facilitation to paired-pulse transcranial magnetic stimulation. This represents the first report investigating effects of immunotherapy on cortical excitability in SPS.

• Authors: Simone Rossi, Monica Ulivelli, Maria Malentacchi, Giuseppe Greco, Sabina Bartalini, Patrizia Borgogni, Fabio Giannini
• Journal: Journal of neurology (J Neurol) Vol. 257 Issue 2 Pg. 281-5 (Feb 2010) ISSN: 1432-1459 [Electronic] Germany
• PMID: 19820984 (Publication Type: Case Reports, Journal Article)

Topics

• Adult
• Electromyography
• Evoked Potentials, Motor (drug effects)
• Female
• Humans
• Immunotherapy
• Motor Cortex (drug effects, physiopathology)
• Neural Inhibition (drug effects)
• Reflex, Startle (drug effects)
• Stiff-Person Syndrome (drug therapy, physiopathology, therapy)
• Time Factors
• Transcranial Magnetic Stimulation
• Treatment Outcome