Premium
Slow Repetitive TMS for Drug‐resistant Epilepsy: Clinical and EEG Findings of a Placebo‐controlled Trial
Author(s) -
Cantello Roberto,
Rossi Simone,
Varrasi Claudia,
Ulivelli Monica,
Civardi Carlo,
Bartalini Sabina,
Vatti Giampaolo,
Cincotta Massimo,
Borgheresi Alessandra,
Zaccara Gaetano,
Quartarone Angelo,
Crupi Domenica,
Laganà Angela,
Inghilleri Maurizio,
Giallonardo Anna Teresa,
Berardelli Alfredo,
Pacifici Loredana,
Ferreri Florinda,
Tombini Mario,
Gilio Francesca,
Quarato Pierpaolo,
Conte Antonella,
Manganotti Paolo,
Bongiovanni Liugi Giuseppe,
Monaco Francesco,
Ferrante Daniela,
Rossini Paolo Maria
Publication year - 2007
Publication title -
epilepsia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.687
H-Index - 191
eISSN - 1528-1167
pISSN - 0013-9580
DOI - 10.1111/j.1528-1167.2006.00938.x
Subject(s) - transcranial magnetic stimulation , electroencephalography , epilepsy , anesthesia , ictal , placebo , medicine , crossover study , motor cortex , psychology , stimulation , audiology , neuroscience , alternative medicine , pathology
Summary: Purpose: To assess the effectiveness of slow repetitive transcranial magnetic stimulation (rTMS) as an adjunctive treatment for drug‐resistant epilepsy. Methods: Forty‐three patients with drug‐resistant epilepsy from eight Italian Centers underwent a randomized, double‐blind, sham‐controlled, crossover study on the clinical and EEG effects of slow rTMS. The stimulus frequency was 0.3 Hz. One thousand stimuli per day were given at the resting motor threshold intensity for 5 consecutive days, with a round coil at the vertex. Results: “Active” rTMS was no better than placebo for seizure reduction. However, it decreased interictal EEG epileptiform abnormalities significantly (p < 0.05) in one‐third of the patients, which supports a detectable biologic effect. No correlation linked the rTMS effects on seizure frequency to syndrome or anatomic classification, seizure type, EEG changes, or resting motor threshold (an index of motor cortex excitability). Conclusions: Although the antiepileptic action was not significant (p > 0.05), the individual EEG reactivity to “active” rTMS may be encouraging for the development of more‐powerful, noninvasive neuromodulatory strategies.