Single and paired pulse transcranial magnetic stimulation in drug naïve epilepsy

Goede, Annika A. de; Braack, Esther Maria Spanjer-ter; Putten, Michel J.A.M. van

doi:10.1016/j.clinph.2016.06.025

Cited by 29 publications

(42 citation statements)

References 170 publications

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“…For example, Appendix B shows a maximal increase or decrease in LICI of around 65% due to a change in coil positioning. However, differences between patients with epilepsy and healthy controls at ISI 250 ms have been reported to be three times as large: inhibition in controls (mean ± SD: 68.3 ± 37.0%), but facilitation in patients (generalized epilepsy: 273.0 ± 106.2%, and ipsilateral hemisphere focal epilepsy: 244.0 ± 76.4%) (Badawy et al 2007 , 2014 , 2017 ; de Goede et al 2016 ). Furthermore, in successfully treated patients facilitation may normalize to inhibition over time, while LICI remains increased in refractory patients (Badawy et al 2013 ).…”

Section: Discussionmentioning

confidence: 99%

Accurate Coil Positioning is Important for Single and Paired Pulse TMS on the Subject Level

2018

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Function-guided navigation is commonly used when assessing cortical excitability using transcranial magnetic stimulation (TMS). However, the required accuracy, stability and the effect of a change in coil positioning are not entirely known. This study investigates the accuracy of function-guided navigation for determining the hotspot. Furthermore, it evaluates the effect of a change in coil location on the single and paired pulse excitability measures: motor evoked potential (MEP) amplitude, TMS evoked potential (TEP) and long intracortical inhibition (LICI), and of a change in coil orientation on LICI. Eight healthy subjects participated in the single pulse study, and ten in the paired pulse study. A robot-guided navigation system was used to ensure accurate and stable coil positioning at the motor hotspot as determined using function-guided navigation. In addition, we targeted four locations at 2 mm and four at 5 mm distance around the initially defined hotspot, and we increased and decreased the coil orientation by 10°. In none of the subjects, the largest MEP amplitudes were evoked at the originally determined hotspot, resulting in a poor accuracy of function-guided navigation. At the group level, a change in coil location had no significant effect on the MEP amplitude, TEP, or LICI, and a change in coil orientation did not significantly affected LICI. However, at the subject level significant effects on MEP amplitude, TEP, and LICI were found for changes in coil location or orientation, although absolute differences were relatively small and did not show a consistent pattern. This study indicates that a high accuracy in coil positioning is especially required to measure cortical excitability reliably in individual subjects using single or paired pulse TMS.Electronic supplementary materialThe online version of this article (10.1007/s10548-018-0655-6) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Accurate Coil Positioning is Important for Single and Paired Pulse TMS on the Subject Level

2018

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“…Which repeatability for each ISI is required ultimately depends on the research question and study population. For example, in epilepsy research it appears that especially ISIs 2, 5, 250 and 300 ms differ significantly between patients and controls (de Goede et al, 2016). Therefore repeatability should be optimal for these particular ISIs, but not necessarily for the others.…”

Section: Discussionmentioning

confidence: 99%

Repeatability of long intracortical inhibition in healthy subjects

Goede

Putten

2017

Clinical Neurophysiology Practice

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“…9 A number of studies have attempted to identify TMS-based biomarkers for diagnosis or prediction of treatment response in the epilepsies. 10,11 In general, these studies have involved relatively heterogenous patient groups, which may have contributed to the paucity of clinically adopted markers. 10,11 Studying TMS in genetically-defined patient groups may decrease inter-individual variability and increase power for detecting clinically useful signatures of pathophysiological processes yielding biomarkers for diagnosis and treatment of these conditions.…”

Section: Introductionmentioning

confidence: 99%

“…10,11 In general, these studies have involved relatively heterogenous patient groups, which may have contributed to the paucity of clinically adopted markers. 10,11 Studying TMS in genetically-defined patient groups may decrease inter-individual variability and increase power for detecting clinically useful signatures of pathophysiological processes yielding biomarkers for diagnosis and treatment of these conditions. This approach has already been employed for several genetic conditions of relevance to epilepsy, which we now review.…”

Section: Introductionmentioning

confidence: 99%

Transcranial magnetic stimulation as a tool to understand genetic conditions associated with epilepsy

et al. 2020

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Single and paired pulse transcranial magnetic stimulation in drug naïve epilepsy

Cited by 29 publications

References 170 publications

Accurate Coil Positioning is Important for Single and Paired Pulse TMS on the Subject Level

Accurate Coil Positioning is Important for Single and Paired Pulse TMS on the Subject Level

Repeatability of long intracortical inhibition in healthy subjects

Transcranial magnetic stimulation as a tool to understand genetic conditions associated with epilepsy

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