Cortical excitability in epilepsy and the impact of antiepileptic drugs: Transcranial magnetic stimulation applications.

Cortical excitability in epilepsy and the impact of antiepileptic drugs: Transcranial magnetic stimulation applications.
Expert Rev Neurother. 2020 Jun 08;:
Authors: Hamed SA
Abstract
INTRODUCTION: Epileptic conditions are characterized by impaired cortical excitation/inhibition balance and interneuronal disinhibition. Transcranial magnetic stimulation (TMS) is a neurophysiological method which assesses brain excitation/inhibition.
AREA COVERED: This review was written after detailed search in PubMed, EMBASE, ISI web of science, SciELO, Scopus and Cochrane Controlled Trials databases from 1990 to 2020. It summarizes TMS applications for diagnostic and therapeutic purposes in epilepsy. TMS studies help to distinguish different epilepsy conditions and explore the antiepileptic drugs' (AEDs') effects on neuronal microcircuits and plasticity mechanisms. Repetitive TMS studies showed that low-frequency rTMS (0.33-1 Hz) can reduce seizures' frequency in refractory epilepsy or pause ongoing seizures; however, there is no current approval for its use in such patients as adjunctive treatment to AEDs.
EXPERT OPINION: There are variable and conflicting TMS results which reflect the distinct pathogenic mechanisms of each epilepsy condition, the dynamic epileptogenic process over the long disease course resulting in the development of recurrent spontaneous seizures and/or progression of epilepsy after it is established, and the differential effect of AEDs o...

Source: Expert Review of Neurotherapeutics - June 9, 2020 Category: Neurology Tags: Expert Rev Neurother Source Type: research