PMID- 24471453
OWN - NLM
STAT- MEDLINE
DCOM- 20141106
LR  - 20151113
IS  - 1468-1331 (Electronic)
IS  - 1351-5101 (Linking)
VI  - 21
IP  - 4
DP  - 2014 Apr
TI  - Relapses in multiple sclerosis: effects of high-dose steroids on cortical 
      excitability.
PG  - 630-6
LID - 10.1111/ene.12356 [doi]
AB  - BACKGROUND AND PURPOSE: High-dose steroid administration is the usual treatment 
      of multiple sclerosis (MS) relapse, but it remains to determine whether this 
      treatment may act by changing the excitability of cortical circuitry. METHODS: 
      The functional cortical effects of high-dose steroids in 21 MS patients before 
      and after 3 days of intravenous administration of methylprednisolone (1 g/day) 
      for the treatment of MS relapse were studied. Investigations included various 
      clinical scales [Kurtzke Functional System Scale (KFSS), Expanded Disability 
      Status Scale and Fatigue Severity Scale, 10-m walk] and transcranial magnetic 
      stimulation (TMS) tests of cortical excitability [resting motor threshold, 
      recruitment curve of motor evoked potentials, short-interval intracortical 
      inhibition (SICI) and intracortical facilitation (ICF) at various interstimuli 
      intervals (ISIs), cortical silent period and interhemispheric inhibition]. 
      RESULTS: Following steroid administration, clinical improvement was significant 
      for the KFSS pyramidal (motor) and total scores, whilst TMS showed a reduction of 
      SICI (mean and maximum values) and an increase of ICF at 10 ms ISI. CONCLUSIONS: 
      Very rapid functional changes in the excitability of cortical circuits involved 
      in motor control can be induced by steroids, before any process of remyelination 
      or axonal regeneration has time to occur. The net effect of steroids on the 
      balance between intracortical GABAergic inhibition and glutamatergic facilitation 
      was in favour of weaker inhibition or stronger facilitation, which could lead to 
      improving the motor performance in MS patients.
CI  - (c) 2014 The Author(s) European Journal of Neurology (c) 2014 EFNS.
FAU - Ayache, S S
AU  - Ayache SS
AD  - EA 4391, Faculte de Medecine de Creteil, Universite Paris Est Creteil, Creteil, 
      France; Service de Physiologie, Explorations Fonctionnelles, Hopital 
      Henri-Mondor, AP-HP, Creteil, France.
FAU - Creange, A
AU  - Creange A
FAU - Farhat, W H
AU  - Farhat WH
FAU - Zouari, H G
AU  - Zouari HG
FAU - Mylius, V
AU  - Mylius V
FAU - Ahdab, R
AU  - Ahdab R
FAU - Abdellaoui, M
AU  - Abdellaoui M
FAU - Lefaucheur, J-P
AU  - Lefaucheur JP
LA  - eng
PT  - Journal Article
DEP - 20140128
PL  - England
TA  - Eur J Neurol
JT  - European journal of neurology
JID - 9506311
RN  - 0 (Glucocorticoids)
RN  - X4W7ZR7023 (Methylprednisolone)
SB  - IM
MH  - Administration, Intravenous
MH  - Adult
MH  - Aged
MH  - Disability Evaluation
MH  - Electric Stimulation
MH  - Electromyography
MH  - Evoked Potentials, Motor/*drug effects/physiology
MH  - Female
MH  - Functional Laterality/drug effects/physiology
MH  - Glucocorticoids/*therapeutic use
MH  - Humans
MH  - Male
MH  - Methylprednisolone/*therapeutic use
MH  - Middle Aged
MH  - Motor Cortex/*drug effects/physiopathology
MH  - Multiple Sclerosis, Relapsing-Remitting/*drug therapy/*pathology
MH  - Neural Inhibition
MH  - Pyramidal Tracts/drug effects/physiopathology
MH  - Reaction Time
MH  - Young Adult
OTO - NOTNLM
OT  - cortical excitability
OT  - intracortical facilitation
OT  - multiple sclerosis
OT  - short-interval intracortical inhibition
OT  - steroids
EDAT- 2014/01/30 06:00
MHDA- 2014/11/07 06:00
CRDT- 2014/01/30 06:00
PHST- 2013/12/08 00:00 [received]
PHST- 2013/12/17 00:00 [accepted]
PHST- 2014/01/30 06:00 [entrez]
PHST- 2014/01/30 06:00 [pubmed]
PHST- 2014/11/07 06:00 [medline]
AID - 10.1111/ene.12356 [doi]
PST - ppublish
SO  - Eur J Neurol. 2014 Apr;21(4):630-6. doi: 10.1111/ene.12356. Epub 2014 Jan 28.