Transcranial magnetic stimulation for the treatment of epilepsy

Chen, Ricky; Spencer, David C.; Weston, Jennifer; Nolan, Sarah J

doi:10.1002/14651858.cd011025.pub2

Cited by 41 publications

(20 citation statements)

References 20 publications

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“…A 2016 Cochrane review of available evidence for the use of TMS to reduce seizure frequency judged the quality to be low [97]. Fregni et al performed a randomized clinical trial of active or sham TMS in 21 patients with malformations of cortical development and refractory epilepsy [98].…”

Section: Transcranial Magnetic Stimulationmentioning

confidence: 99%

A Review of Neurostimulation for Epilepsy in Pediatrics

et al. 2019

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Neurostimulation for epilepsy refers to the application of electricity to affect the central nervous system, with the goal of reducing seizure frequency and severity. We review the available evidence for the use of neurostimulation to treat pediatric epilepsy, including vagus nerve stimulation (VNS), responsive neurostimulation (RNS), deep brain stimulation (DBS), chronic subthreshold cortical stimulation (CSCS), transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS). We consider possible mechanisms of action and safety concerns, and we propose a methodology for selecting between available options. In general, we find neurostimulation is safe and effective, although any high quality evidence applying neurostimulation to pediatrics is lacking. Further research is needed to understand neuromodulatory systems, and to identify biomarkers of response in order to establish optimal stimulation paradigms.

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Section: Transcranial Magnetic Stimulationmentioning

confidence: 99%

A Review of Neurostimulation for Epilepsy in Pediatrics

et al. 2019

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“…The US FDA has approved neuromodulation devices which operate on the basis of deep brain stimulation (DBS), vagus nerve stimulation (VNS), and responsive neurostimulation (RNS) [9]. Other devices using transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS) have been reported to provide noninvasive brain stimulation, but clinical trials have shown no benefit [13,14]. A primary limitation of TMS is that the inductive field decreases sharply and does not allow efficient energy deposition for subcortical stimulation [15].…”

Section: Introductionmentioning

confidence: 99%

Transcranial focused ultrasound pulsation suppresses pentylenetetrazol induced epilepsy in vivo

et al. 2020

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Background: Epilepsy is a neurological disorder characterized by abnormal neuron discharge, and onethird of epilepsy patients suffer from drug-resistant epilepsy (DRE). The current management for DRE includes epileptogenic lesion resection, disconnection, and neuromodulation. Neuromodulation is achieved through invasive electrical stimulus including deep brain stimulation, vagus nerve stimulation, or responsive neurostimulation (RNS). As an alternative therapy, transcranial focused ultrasound (FUS) can transcranially and non-invasively modulate neuron activity. Objective: This study seeks to verify the use of FUS pulsations to suppress spikes in an acute epileptic small-animal model, and to investigate possible biological mechanisms by which FUS pulsations interfere with epileptic neuronal activity. Methods: The study used a total of 76 Sprague-Dawley rats. For the epilepsy model, rats were administered pentylenetetrazol (PTZ) to induce acute epileptic-like abnormal neuron discharges, followed by FUS exposure. Various ultrasound parameters were set to test the epilepsy-suppressing effect, while concurrently monitoring and analyzing electroencephalogram (EEG) signals. Animal behavior was monitored and histological examinations were conducted to evaluate the hazard posed by ultrasound exposure and the expression of neuronal activity markers. Western blotting was used to evaluate the correlation between FUS-induced epileptic suppression and the PI3K-mTOR signaling pathway. Results: We observed that FUS pulsations effectively suppressed epileptic activity and observed EEG spectrum oscillations; the spike-suppressing effect depended on the selection of ultrasound parameters and highly correlated with FUS exposure level. Expression level changes of c-Fos and GAD65 were confirmed in the cortex and hippocampus, indicating that FUS pulsations deactivated excitatory cells and activated GABAergic terminals. No tissue damage, inflammatory response, or behavioral abnormalities were observed in rats treated with FUS under these exposure parameters. We also found that the FUS pulsations down-regulated the S6 phosphorylation and decreased pAKT expression. Conclusion: Our results suggest that pulsed FUS exposure effectively suppresses epileptic spikes in an acute epilepsy animal model, and finds that ultrasound pulsation interferes with neuronal activity and affects the PTZ-induced PI3K-Akt-mTOR pathway, which might help explain the mechanism underlying ultrasound-related epileptic spike control.

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“…Low frequency repetitive rTMS (0.3-1 Hz) decreases cortical excitability, suggesting a potential therapeutic advantage for patients with drug-resistant epilepsy (Jan et al, 2017;Gersner et al, 2016). Chen et al (2016) retrospectively analyzed the evidence for the efficacy of TMS in drug-resistant epilepsy, evaluating studies that used rTMS of any frequency, duration, intensity and setup (focal or vertex treatment). Excruciatingly, the evidence for efficacy of rTMS for reduction in seizure rate/frequency is still lacking, due to the extreme variability in outcome reporting (Jan et al, 2017).…”

Section: Discussionmentioning

confidence: 99%

The Mathematics Underlying Eeg Oscillations Propagation

Tozzi

Bormashenko

Jaušovec³

2020

Preprint

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Whenever one attempts to comb a hairy ball flat, there will always be at least one tuft of hair at one point on the ball. This seemingly worthless sentence is an informal description of the hairy ball theorem, an invaluable mathematical weapon that has been proven useful to describe a variety of physical/biological processes/phenomena in terms of topology, rather than classical cause/effect relationships. In this paper we will focus on the electrical brain field -electroencephalogram (EEG). As a starting point we consider the recentlyraised observation that, when electromagnetic oscillations propagate with a spherical wave front, there must be at least one point where the electromagnetic field vanishes. We show how this description holds also for the electric waves produced by the brain and detectable by EEG. Once located these zero-points in EEG traces, we confirm that they are able to modify the electric wave fronts detectable in the brain. This sheds new light on the functional features of a nonlinear, metastable nervous system at the edge of chaos, based on the neuroscientific model of Operational Architectonics of brain-mind functioning. As an example of practical application of this theorem, we provide testable previsions, suggesting the proper location of transcranial magnetic stimulation's coils to improve the clinical outcomes of drug-resistant epilepsy.

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Transcranial magnetic stimulation for the treatment of epilepsy

Cited by 41 publications

References 20 publications

A Review of Neurostimulation for Epilepsy in Pediatrics

A Review of Neurostimulation for Epilepsy in Pediatrics

Transcranial focused ultrasound pulsation suppresses pentylenetetrazol induced epilepsy in vivo

The Mathematics Underlying Eeg Oscillations Propagation

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