Safety of repetitive transcranial magnetic stimulation in patients with epilepsy: A systematic review

Pereira, Luisa Santos; Müller, Vanessa Teixeira; Gomes, Marleide da Mota; Rotenberg, Alexander; Fregni, Felipe

doi:10.1016/j.yebeh.2016.01.015

Cited by 76 publications

(50 citation statements)

References 53 publications

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“…Besides, Acoustic stimulation could promote the release of acetylcholine in the brainstem structures involved in the initiation of PGO waves. Perhaps, these influences mediated by changing in membrane ion channel permeability, which occur under the influence of lowfrequency EMF (1,12,14) . Also, we suggest that EMF exposure on brain results changes in electric and current density fields, accompanied by modification of synaptic activity, modes of synchronous bursts of neuronal populations, ion dynamics, and other phenomena.…”

Section: Resultsmentioning

confidence: 99%

“…(2,7) . EMF exposure can also be used as a separate treatment therapy (12) . Furthermore, repetitive TMS (Transcranial Magnetic Stimulation) seen as a safe treatment method, without enduring side effects: no long-term neurological, cognitive, or cardiovascular side effects reported.…”

Section: Introductionmentioning

confidence: 99%

“…The EMF appears to be biologically active, penetrating into the living tissue without any impediments (3,12) . However, it is unclear how the lowfrequency EMF can block seizure activity.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The Acoustic Range Electric-magnetic Field Depresses Behavioral Seizure Activity

Bukia¹,

Kekelia²,

Machavariani³

et al. 2017

IAM

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In the present study, we examined the effect of an acoustic range of electric-magnetic field (EMF) on the behavioral manifestation of seizure in genetically epilepsy-prone rats (GEPRs) of Krushinsky-Molodkina strain. A 5-days exposure to EMF (10000 -15000 Hz frequency, 1,5 m/Tesla, during 20 min) resulted in partial or complete suppression of behavior seizure activity in GEPRs. Besides, on the background of EMF, the latency period of the first wild run was increased. On the same conditions, duration of wild run decreased. Audiogenic stimuli obtained in GEPRs changed the ECoG activity of sensomotoral cortex only in audiogenallykindled animals. Findings of this study suggest that the regulation of the behavioral manifestation of seizure in GEPRs does not involve the cortex; it is mainly regulated by brainstem structures. We concluded that acoustic range of EMF could apply for suppression of behavioral manifestation of the seizure. Audiogenic stimuli obtained in GEPRs changed the ECoG activity of sensomotoral cortex only in audiogenally-kindled animals. Findings of this study suggest that the regulation of the behavioral manifestation of seizure in GEPRs does not involve the cortex; it is mainly regulated by brainstem structures. Rostral part of the cortex has a significant role in the manifestation of seizure activity in audiogenly kindling GEPRs. We concluded that acoustic range of EMF could apply for suppression of behavioral manifestation of the seizure.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The Acoustic Range Electric-magnetic Field Depresses Behavioral Seizure Activity

Bukia¹,

Kekelia²,

Machavariani³

et al. 2017

IAM

View full text Add to dashboard Cite

show abstract

“…(4,8,9) . EMF also can be used as a separate treatment therapy (14) . Transcranially applied weak fields generated by DC and AC have a wide variety of effects that are potentially significant for using the therapy.…”

Section: Introductionmentioning

confidence: 99%

“…Furthermore, repetitive transcranial magnetic stimulation (rTMS) is seen as a safe treatment method, without enduring side effects: no longterm neurological, cognitive or cardiovascular side effects are reported (18,19) . EMF appears to be biologically active, penetrating into the living tissue without any impediments (14) . However, it is unclear how the low-frequency EMF can block seizure activity.…”

Section: Introductionmentioning

confidence: 99%

The Electromagnetic Field Changes on Emotional-motivated Behavior in Genetically Epilepsy-prone Rats

Bukia¹,

Kekelia²,

Butskhrikidze³

et al. 2017

IAM

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In the present study, we examined the effects of acoustic range electromagnetic field (EMF) on emotional-motivated behavior in genetically epilepsy-prone rats (GEPRs) of Krushinsky-Molodkina strain in Open field test. A 5-days exposure by EMF (10 -15 kHz, 1,5 mlTl, duration 20 min) resulted in partial or complete suppression of behavior seizure activity in GEPRs. The anxiety degree in irradiated GEPRs versus the controls (GEPRs without EMF exposure) was decreased, whereas the locomotion/exploratory activity was increased. A 5-days exposure by EMF in inbred white rats also changed the locomotion/exploratory activity in Open field test. We conclude that acoustic range of EMF can apply for suppression of behavioral manifestation of the seizure. These data support a potential role of EMF exposure in changing emotion regulation of anxiety, but the mechanisms of such influence are not known. Proposed biological mechanisms in anti-seizure and anxiolytic effects of EMF exposure in GEPRs might include normalization of neuroendocrine, neurotransmitter, and/or neurotrophic factors.

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Repetitive transcranial magnetic stimulation for the treatment of drug‐resistant epilepsy: A systematic review and individual participant data meta‐analysis of real‐world evidence

et al. 2017

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SummaryObjectiveTo perform a systematic review and meta‐analysis of real‐world evidence for the use of low‐frequency repetitive transcranial magnetic stimulation (rTMS) in the treatment of drug‐resistant epilepsy.MethodsWe systematically searched PubMed, Scopus, Medline, and clinicaltrials.gov for all relevant articles. Relevant patient and stimulation predictors as well as seizure outcomes were assessed. For studies with and without individual participant data (IPD), the primary outcomes were the rate of “favorable response” (reduction in seizure frequency ≥50%) and pooled event rate of mean reduction in seizure frequency, respectively. Outcomes were assessed with comparative statistics and random‐effects meta‐analysis models.ResultsOf 3,477 identified articles, 12 met eligibility and were included in this review. We were able to obtain IPD for 5 articles constituting 34 participants. Univariate analysis on IPD identified greater favorable response event rates between participants with temporal seizure focus versus extratemporal (50% vs. 14%, p = 0.045) and between participants who were stimulated with a figure‐8 coil versus other types (47% vs. 0%, p = 0.01). We also performed study‐level meta‐analysis on the remaining 7 studies without IPD, which included 212 participants. The pooled mean event rate of 50% seizure reduction using low‐frequency rTMS was 30% (95% confidence interval [CI] 12–57%). Sensitivity analysis revealed that studies with a mean age ≤21 years and studies using targeted stimulation had the highest seizure reduction rates compared to studies with a mean age >21 years (69% vs. 18%) and not using a targeted stimulation (47% vs. 14–20%). Moreover, we identified high interstudy heterogeneity, moderate study bias, and high publication bias.SignificanceReal‐world evidence suggests that low‐frequency rTMS using a figure‐8 coil may be an effective therapy for the treatment of drug‐resistant epilepsy in pediatric patients. This meta‐analysis can inform the design and expedite recruitment of a subsequent randomized clinical trial.

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Safety of repetitive transcranial magnetic stimulation in patients with epilepsy: A systematic review

Cited by 76 publications

References 53 publications

The Acoustic Range Electric-magnetic Field Depresses Behavioral Seizure Activity

The Acoustic Range Electric-magnetic Field Depresses Behavioral Seizure Activity

The Electromagnetic Field Changes on Emotional-motivated Behavior in Genetically Epilepsy-prone Rats

Repetitive transcranial magnetic stimulation for the treatment of drug‐resistant epilepsy: A systematic review and individual participant data meta‐analysis of real‐world evidence

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