Effects of mexiletine on hyperexcitability in sporadic amyotrophic lateral sclerosis: Preliminary findings from a small phase II randomized controlled trial.
Muscle Nerve
; 63(3): 371-383, 2021 03.
Article
in En
| MEDLINE
| ID: mdl-33340120
ABSTRACT
BACKGROUND:
To collect preliminary data on the effects of mexiletine on cortical and axonal hyperexcitability in sporadic amyotrophic lateral sclerosis (ALS) in a phase 2 double-blind randomized controlled trial.METHODS:
Twenty ALS subjects were randomized to placebo and mexiletine 300 or 600 mg daily for 4 wk and assessed by transcranial magnetic stimulation and axonal excitability studies. The primary endpoint was change in resting motor threshold (RMT).RESULTS:
RMT was unchanged with 4 wk of mexiletine (combined active therapies) as compared to placebo, which showed a significant increase (P = .039). Reductions of motor evoked potential (MEP) amplitude (P = .013) and accommodation half-time (P = .002), secondary outcome measures of cortical and axonal excitability, respectively, were also evident at 4 wk on mexiletine.CONCLUSIONS:
The relative stabilization of RMT in the treated subjects was unexpected and could be attributed to unaccounted sources of error or chance. However, a possible alternative cause is neuromodulation preventing an increase. The change in MEP amplitude and accommodation half-time supports the reduction of cortical and axonal hyperexcitability with mexiletine.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Axons
/
Voltage-Gated Sodium Channel Blockers
/
Cortical Excitability
/
Amyotrophic Lateral Sclerosis
/
Mexiletine
Type of study:
Clinical_trials
/
Diagnostic_studies
Limits:
Adult
/
Aged
/
Female
/
Humans
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Male
/
Middle aged
Language:
En
Journal:
Muscle Nerve
Year:
2021
Document type:
Article
Affiliation country:
Estados Unidos