A facilitation tool: transcranial magnetic stimulation in epilepsy research

Abstract

Transcranial magnetic stimulation (TMS) is a noninvasive and relatively safe method to modulate the cortical activities and thus becomes popular in clinical research such as epilepsy studies. These studies mainly focus on the use of paired-pulse TMS as biomarkers and the effects of repetitive TMS (rTMS) in epilepsy treatment. Paired-pulse TMS measures the cortical excitability under different pathological circumstances by deriving and analyzing paired-pulse recovery curve, which has been proved reliable and widely used to study the physiological and pharmacological mechanisms in epilepsy. rTMS is able to modulate the brain functions and has been considered as a potential treatment for epilepsy, yet the evidence is insufficient and further exploration is required. This review intends to examine the methodologies and outcomes presented by relevant studies and to discuss the pros and cons of current TMS research. This review gives a brief introduction to background and principle of TMS. It reviews the methods measuring cortical excitability and the key findings in accordance with the mechanisms of epilepsy. It also reviews the existing controlled studies in therapeutic effectiveness of rTMS and analyzes the advantages of different designs and parameter choices.In the end, this review suggests directions for future research.