Spontaneously Fluctuating Motor Cortex Excitability in Alternating Hemiplegia of Childhood: A Transcranial Magnetic Stimulation Study
This study used TMS to study motor cortex excitability in people with AHC. Low excitability was found during hemiplegic attacks. Between attacks, cortical excitability showed asymptomatic fluctuations, not seen in controls. We hypothesize that the asymptomatic excitability changes we observed were due to altered function of the ATP1A3 mutant protein, and that larger fluctuations, either spontaneous or triggered by external factors, cause hemiplegic attacks. It is possible that the observed fluctuation might act as a biomarker for disease activity, providing information as a surrogate for hemiplegic attacks that occur on a much longer time scale. Such a biomarker might be of value, for example, for trials of novel treatments for AHC.
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