Wan-Yu Hsu1, Chia-Hsiung Cheng, Ming-Wei Lin, Yang-Hsin Shih, Kwong-Kum Liao, Yung-Yang Lin. 1. Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan; Laboratory of Neurophysiology, Taipei Veterans General Hospital, Taipei, Taiwan; Integrated Brain Research Laboratory, Taipei Veterans General Hospital, Taipei, Taiwan.
Abstract
PURPOSE: To evaluate the antiepileptic efficacy of low frequency repetitive transcranial magnetic stimulation (rTMS) in medically intractable epilepsy. METHODS: A comprehensive literature search was performed on articles published from 1990 to 2010 in Medline, Pubmed, CINAHL, and Cochrane using the following keywords: epilepsy, seizure, transcranial magnetic stimulation, repetitive transcranial magnetic stimulation. Two reviewers assessed article eligibility and extracted the data independently. For outcome measures, effect size and 95% confidence interval (CI) were calculated for seizure frequency, spike number, duration of epileptiform abnormalities (EAs), and resting motor threshold (RMT) by using fixed and random effect models. RESULTS: Eleven articles were identified, with a total of 164 participants. Based on seizure frequency, a significant effect size was found (effect size: 0.34, with a 95% CI at 0.10-0.57). Considering between-study heterogeneity, we conducted a second meta-analysis, and the underlying etiology was considered important for the treatment effect. Cortical dysplasia or neocortical epilepsy showed an effect size of 0.71, with a 95% CI at 0.30-1.12. In contrast, other epileptic disorders showed an effect size of 0.22. CONCLUSION: Low frequency rTMS has a favorable effect on seizure reduction, particularly evident in patients with neocortical epilepsy or cortical dysplasia.
PURPOSE: To evaluate the antiepileptic efficacy of low frequency repetitive transcranial magnetic stimulation (rTMS) in medically intractable epilepsy. METHODS: A comprehensive literature search was performed on articles published from 1990 to 2010 in Medline, Pubmed, CINAHL, and Cochrane using the following keywords: epilepsy, seizure, transcranial magnetic stimulation, repetitive transcranial magnetic stimulation. Two reviewers assessed article eligibility and extracted the data independently. For outcome measures, effect size and 95% confidence interval (CI) were calculated for seizure frequency, spike number, duration of epileptiform abnormalities (EAs), and resting motor threshold (RMT) by using fixed and random effect models. RESULTS: Eleven articles were identified, with a total of 164 participants. Based on seizure frequency, a significant effect size was found (effect size: 0.34, with a 95% CI at 0.10-0.57). Considering between-study heterogeneity, we conducted a second meta-analysis, and the underlying etiology was considered important for the treatment effect. Cortical dysplasia or neocortical epilepsy showed an effect size of 0.71, with a 95% CI at 0.30-1.12. In contrast, other epileptic disorders showed an effect size of 0.22. CONCLUSION: Low frequency rTMS has a favorable effect on seizure reduction, particularly evident in patients with neocortical epilepsy or cortical dysplasia.
Authors: Yonatan A Cooper; Sean T Pianka; Naif M Alotaibi; Diana Babayan; Bahar Salavati; Alexander G Weil; George M Ibrahim; Anthony C Wang; Aria Fallah Journal: Epilepsia Open Date: 2017-12-27