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Methods to Quantify Pharmacologically Induced Alterations in Motor Function in Human Incomplete SCI

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Bupropion decreases resting motor threshold: a case report.

Mustafa A Mufti¹, Paul E Holtzheimer, Charles M Epstein

¹Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia, USA.

Brain Stimulation

|July 17, 2010

Summary

Bupropion at 300 mg/d significantly lowered resting motor threshold (RMT), indicating increased cortical excitability and seizure risk. Lowering the dose to 150 mg/d returned RMT to baseline levels.

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Area of Science:

Neuroscience
Pharmacology
Clinical Neurophysiology

Background:

Bupropion is linked to a dose-dependent increase in seizure risk.
This effect may stem from alterations in motor cortex excitability.
Transcranial magnetic stimulation (TMS) measures resting motor threshold (RMT) to assess cortical excitability.

Observation:

Resting motor threshold (RMT) was measured in a patient undergoing repetitive TMS (rTMS) for depression.
Measurements were taken before and during bupropion administration at 150 mg/d and 300 mg/d.
A significant decrease in RMT was observed at the 300 mg/d bupropion dose.

Findings:

Bupropion at 300 mg/d significantly reduced RMT, indicating increased motor cortex excitability.
Reducing the bupropion dose to 150 mg/d normalized RMT to pre-treatment levels.
This suggests a direct correlation between higher bupropion dosage and enhanced cortical excitability.

Implications:

Higher bupropion doses (300 mg/d) increase cortical excitability, potentially explaining the associated seizure risk.
Regular RMT monitoring is crucial during rTMS treatment, particularly when adjusting bupropion dosage.
This highlights the importance of pharmacologically informed neuromodulation protocols.