Transcranial Magnetic Stimulation (TMS) of the Brain in Patients with Mesiotemporal Epileptic Foci

Steinhoff, Bernhard J.; Stodieck, Stefan; Zivcec, Zdravko; Schreiner, Ralph; Maffei, Christian von; Plendl, H.; Paulus, Walter

doi:10.1177/155005949302400103

Cited by 37 publications

(19 citation statements)

References 10 publications

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“…We could confirm the findings of most groups that TMS seems to be safe for investigational purpose in epilepsy patients [6,26,[33][34][35][38][39][40].…”

Section: Resultssupporting

confidence: 85%

Changes in interhemispheric inhibition following successful epilepsy surgery: a TMS study

et al. 2010

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Epileptic foci can influence cortical excitability, brain perfusion and metabolism not only directly in the focus or perifocally, but also in remote areas. Effects of successful epilepsy surgery on cortical networks and changes in excitability have rarely been addressed. We report a study on changes in interhemispheric inhibition following successful surgical removal of an epileptic focus. Eighteen patients (11 females, 7 males, mean age 34.2 years) were enrolled in this transcranial magnetic stimulation (TMS) study. All patients were seizure free after surgery and had identical antiepileptic medication pre- and postsurgically. Investigations were performed before and at least 3 months after surgery. Motor thresholds (MT) and motor evoked potentials (MEPs) of interhemispheric paired pulse paradigms were investigated on both hemispheres. Resection of the epileptic focus resulted in a significant change in interhemispheric inhibition (IHI). The ability of the non-focal hemisphere to inhibit the motor cortex (M1) of the focal hemisphere significantly increased (p=0.02) and normalized to the level of the other hemisphere. In summary, this TMS study suggests that an epileptic focus can modulate interhemispheric inhibitory interactions between the motor cortices. A decreased susceptibility of M1 of the focal hemisphere or alterations in the non-focal hemispheric inhibitory output may be underlying mechanisms. These findings may contribute to a better understanding of widespread functional impairments in focal epilepsy.

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“…We could confirm the findings of most groups that TMS seems to be safe for investigational purpose in epilepsy patients [6,26,[33][34][35][38][39][40].…”

Section: Resultssupporting

confidence: 85%

Changes in interhemispheric inhibition following successful epilepsy surgery: a TMS study

et al. 2010

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“…Nineteen patients with mesiotemporal epileptogenic foci were treated with 0.1-to 0.3-Hz TMS to determine its safety and potential benefits. None of the patients had significant spike activation, and several had bilateral reduction of epileptiform activity (13). Nine patients participated in a pilot study of TMS for refractory partial epilepsies by the same group.…”

Section: Transcranial Magnetic Stimulation (Tms): Fields With High Flmentioning

confidence: 99%

Magnetic Field Therapy for Epilepsy

McLean¹,

Engström

Holcomb

2001

Epilepsy & Behavior

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“…Basierend auf der zufälligen Beobachtung,dass wiederholte TMS-Pulse mit einer Frequenz von 0,3 Hz einen hemmenden Einfluss auf die Rate epilepsietypischer Muster im EEG von Patienten mit mesiotemporaler Epilepsie haben [101], entstand das hypothetische Konzept,dass die niederfrequente rTMS die kortikale Hemmung bei Patienten mit Epilepsie verstärken bzw. die Übererregbarkeit normalisieren und auf diese Weise das Auftreten von Anfällen verhindern könnte.…”

Section: Transkranielle Magnetstimulation Und Epilepsieunclassified

Elektrische Hirnstimulation in der Epilepsietherapie

et al. 2003

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Attempts to control epileptic seizures by electrical brain stimulation have been performed for 50 years. Many different stimulation targets and methods have been investigated. Vagal nerve stimulation (VNS) is now approved for the treatment of refractory epilepsies by several governmental authorities in Europe and North America. However, it is mainly used as a palliative method when patients do not respond to medical treatment and epilepsy surgery is not possible. Numerous studies of the effect of deep brain stimulation (DBS) on epileptic seizures have been performed and almost invariably report remarkable success. However, a limited number of controlled studies failed to show a significant effect. Repetitive transcranial magnetic stimulation (rTMS) also was effective in open studies, and controlled studies are now being carried out. In addition, several uncontrolled reports describe successful treatment of refractory status epilepticus with electroconvulsive therapy (ECT). In summary, with the targets and stimulation parameters investigated so far, the effects of electrical brain stimulation on seizure frequency have been moderate at best. In the animal laboratory, we are now testing high-intensity, low-frequency stimulation of white matter tracts directly connected to the epileptogenic zone (e.g., fornix, corpus callosum) as a new methodology to increase the efficacy of DBS ("overdrive method").

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Transcranial Magnetic Stimulation (TMS) of the Brain in Patients with Mesiotemporal Epileptic Foci

Cited by 37 publications

References 10 publications

Changes in interhemispheric inhibition following successful epilepsy surgery: a TMS study

Changes in interhemispheric inhibition following successful epilepsy surgery: a TMS study

Magnetic Field Therapy for Epilepsy

Elektrische Hirnstimulation in der Epilepsietherapie

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