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Effects of Repetitive Transcranial Magnetic Stimulation on Spike Pattern and Topography in Patients with Focal Epilepsy

Brain Topography volume 22, Article number: 267 (2010) Cite this article

Abstract

Repetitive Transcranial Magnetic Stimulation (rTMS) is a non-invasive method for brain stimulation. Group-studies applying rTMS in epilepsy patients aiming to decrease epileptic spike- or seizure-frequency have led to inconsistent results. Here we studied whether therapeutic trains of rTMS have detectable effects on individual spike pattern and/or frequency in patients suffering from focal epilepsy. Five patients with focal epilepsy underwent one session of rTMS online with EEG using a 6 Hz prime/1 Hz rTMS protocol (real and sham). The EEG was recorded continuously throughout the stimulation, and the epileptic spikes recorded immediately before (baseline) and after stimulation (sham and real) were subjected to further analysis. Number of spikes, spike-strength and spike-topography were examined. In two of the five patients, real TMS led to significant changes when compared to baseline and sham (decrease in spike-count in one patient, change in topography of the after-discharge in the other patient). Spike-count and topography remained unchanged the remaining patients. Overall, our results do not indicate a consistent effect of rTMS stimulation on interictal spike discharges, but speak in favor of a rather weak and individually variable immediate effect of rTMS on focal epileptic activity. The individuation of most effective stimulation patterns will be decisive for the future role of rTMS in epilepsies and needs to be determined in larger studies.

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Acknowledgments

The work was supported by the Swiss National Science Foundation by the grant No 320030-122073, No. 3200-113766 (M.S.), No. 3200-111783 (C.M.) and SPUM 33CM30-124089. The data were analyzed with the Cartool software (http://brainmapping.unige.ch/Cartool.htm) which is developed by Denis Brunet, from the Functional Brain Mapping Laboratory, Geneva, supported by the Center for Biomedical Imaging (CIBM), Geneva and Lausanne, Switzerland.

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Authors and Affiliations

  1. Functional Brain Mapping Laboratory, University Hospital Geneva, Geneva, Switzerland

    Verena Brodbeck & Christoph M. Michel

  2. Department of Psychology, Centre for Cognitive Neuroimaging, University of Glasgow, Glasgow, Scotland, UK

    Gregor Thut & Vincenzo Romei

  3. Department of Neurology, Presurgical Evaluation Unit, University Hospital Geneva, 24, Rue Micheli-du-Crest, 1211, Geneva, Switzerland

    Laurent Spinelli, Remi Tyrand & Margitta Seeck

  4. Neurology Department, University Hospital Frankfurt, Schleusenweg 2-16, 60528, Frankfurt am Main, Germany

    Verena Brodbeck

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  1. Verena Brodbeck
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  2. Gregor Thut
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  3. Laurent Spinelli
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  4. Vincenzo Romei
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  5. Remi Tyrand
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  6. Christoph M. Michel
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  7. Margitta Seeck
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Correspondence to Verena Brodbeck or Margitta Seeck.

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This is one of several papers published together in Brain Topography on the “Special Topic: TMS and EEG”

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Brodbeck, V., Thut, G., Spinelli, L. et al. Effects of Repetitive Transcranial Magnetic Stimulation on Spike Pattern and Topography in Patients with Focal Epilepsy. Brain Topogr 22, 267 (2010). https://doi.org/10.1007/s10548-009-0125-2

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  • DOI: https://doi.org/10.1007/s10548-009-0125-2

Keywords

  • Repetitive TMS
  • Epilepsy
  • Spike Pattern