Quadripulse transcranial magnetic stimulation inducing long-term depression in healthy subjects may increase seizure risk in some patients with intractable epilepsy
Objective: This study aimed to assess the efficacy and safety of quadripulse transcranial magnetic stimulation-50 (QPS-50) in patients with intractable epilepsy. Methods: Four patients were included in the study. QPS-50, which induces long-term depression in healthy subjects, was administered for 30...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-01-01
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| Series: | Clinical Neurophysiology Practice |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2467981X23000173 |
| _version_ | 1797387888722182144 |
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| author | Setsu Nakatani-Enomoto Ritstuko Hanajima Masashi Hamada Hideyuki Matsumoto Yasuo Terao Stefan Jun Groiss Takenobu Murakami Mitsunari Abe Hiroyuki Enomoto Kensuke Kawai Rumiko Kan Shin-ichi Niwa Hirooki Yabe Yoshikazu Ugawa |
| author_facet | Setsu Nakatani-Enomoto Ritstuko Hanajima Masashi Hamada Hideyuki Matsumoto Yasuo Terao Stefan Jun Groiss Takenobu Murakami Mitsunari Abe Hiroyuki Enomoto Kensuke Kawai Rumiko Kan Shin-ichi Niwa Hirooki Yabe Yoshikazu Ugawa |
| author_sort | Setsu Nakatani-Enomoto |
| collection | DOAJ |
| description | Objective: This study aimed to assess the efficacy and safety of quadripulse transcranial magnetic stimulation-50 (QPS-50) in patients with intractable epilepsy. Methods: Four patients were included in the study. QPS-50, which induces long-term depression in healthy subjects, was administered for 30 min on a weekly basis for 12 weeks. Patients’ clinical symptoms and physiological parameters were evaluated before, during, and after the repeated QPS-50 period. We performed two control experiments: the effect in MEP (Motor evoked potential) size after a single QPS-50 session with a round coil in nine healthy volunteers, and a follow-up study of physiological parameters by repeated QPS-50 sessions in four other healthy participants. Results: Motor threshold (MT) decreased during the repeated QPS-50 sessions in all patients. Epileptic symptoms worsened in two patients, whereas no clinical worsening was observed in the other two patients. In contrast, MT remained unaffected for 12 weeks in all healthy volunteers. Conclusions: QPS-50 may not be effective as a treatment for intractable epilepsy. Significance: In intractable epilepsy patients, administering repeated QPS-50 may paradoxically render the motor cortex more excitable, probably because of abnormal inhibitory control within the epileptic cortex. The possibility of clinical aggravation should be seriously considered when treating intractable epilepsy patients with non-invasive stimulation methods. |
| first_indexed | 2024-03-08T22:31:40Z |
| format | Article |
| id | doaj.art-be94ee5888e84e92b0a97edfc400ef0d |
| institution | Directory Open Access Journal |
| issn | 2467-981X |
| language | English |
| last_indexed | 2024-03-08T22:31:40Z |
| publishDate | 2023-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Clinical Neurophysiology Practice |
| spelling | doaj.art-be94ee5888e84e92b0a97edfc400ef0d2023-12-18T04:24:33ZengElsevierClinical Neurophysiology Practice2467-981X2023-01-018137142Quadripulse transcranial magnetic stimulation inducing long-term depression in healthy subjects may increase seizure risk in some patients with intractable epilepsySetsu Nakatani-Enomoto0Ritstuko Hanajima1Masashi Hamada2Hideyuki Matsumoto3Yasuo Terao4Stefan Jun Groiss5Takenobu Murakami6Mitsunari Abe7Hiroyuki Enomoto8Kensuke Kawai9Rumiko Kan10Shin-ichi Niwa11Hirooki Yabe12Yoshikazu Ugawa13Department of Neurology, School of Medicine, Fukushima Medical University, Fukushima, Japan; Department of Neurology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Department of Rehabilitation, Faculty of Health Care and Medical Sports, Teikyo Heisei University, Chiba, Japan; Corresponding author at: Department of Rehabilitation, Faculty of Health Care and Medical Sports, Teikyo Heisei University, UruidoMinami 4-1, Ichihara-city, Chiba 290-0193, Japan.Department of Neurology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Division of Neurology, Department of Brain and Neurosciences, Faculty of Medicine, Tottori University, Tottori, JapanDepartment of Neurology, Graduate School of Medicine, The University of Tokyo, Tokyo, JapanDepartment of Neurology, Graduate School of Medicine, The University of Tokyo, Tokyo, JapanDepartment of Neurology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Department of Cell Physiology, Kyorin University School of Medicine, Tokyo, JapanDepartment of Neurology, School of Medicine, Fukushima Medical University, Fukushima, Japan; Department of Neurology—Center for Movement Disorders and Neuromodulation—and Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich-Heine University, Düsseldorf, GermanyDepartment of Neurology, School of Medicine, Fukushima Medical University, Fukushima, Japan; Division of Neurology, Department of Brain and Neurosciences, Faculty of Medicine, Tottori University, Tottori, JapanDepartment of Neurology, School of Medicine, Fukushima Medical University, Fukushima, JapanDepartment of Neurology, School of Medicine, Fukushima Medical University, Fukushima, JapanDepartment of Neurosurgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan; Department of Neurosurgery, Jichi Medical University, Tochigi, JapanDepartment of Neuropsychiatry, School of Medicine, Fukushima Medical University, Fukushima, JapanDepartment of Neuropsychiatry, School of Medicine, Fukushima Medical University, Fukushima, JapanDepartment of Neuropsychiatry, School of Medicine, Fukushima Medical University, Fukushima, JapanDepartment of Neurology, School of Medicine, Fukushima Medical University, Fukushima, Japan; Department of Neurology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Department of Human Neurophysiology, School of Medicine, Fukushima Medical University, Fukushima, JapanObjective: This study aimed to assess the efficacy and safety of quadripulse transcranial magnetic stimulation-50 (QPS-50) in patients with intractable epilepsy. Methods: Four patients were included in the study. QPS-50, which induces long-term depression in healthy subjects, was administered for 30 min on a weekly basis for 12 weeks. Patients’ clinical symptoms and physiological parameters were evaluated before, during, and after the repeated QPS-50 period. We performed two control experiments: the effect in MEP (Motor evoked potential) size after a single QPS-50 session with a round coil in nine healthy volunteers, and a follow-up study of physiological parameters by repeated QPS-50 sessions in four other healthy participants. Results: Motor threshold (MT) decreased during the repeated QPS-50 sessions in all patients. Epileptic symptoms worsened in two patients, whereas no clinical worsening was observed in the other two patients. In contrast, MT remained unaffected for 12 weeks in all healthy volunteers. Conclusions: QPS-50 may not be effective as a treatment for intractable epilepsy. Significance: In intractable epilepsy patients, administering repeated QPS-50 may paradoxically render the motor cortex more excitable, probably because of abnormal inhibitory control within the epileptic cortex. The possibility of clinical aggravation should be seriously considered when treating intractable epilepsy patients with non-invasive stimulation methods.http://www.sciencedirect.com/science/article/pii/S2467981X23000173Quadripulse transcranial magnetic stimulationIntractable epilepsySeizureMotor threshold |
| spellingShingle | Setsu Nakatani-Enomoto Ritstuko Hanajima Masashi Hamada Hideyuki Matsumoto Yasuo Terao Stefan Jun Groiss Takenobu Murakami Mitsunari Abe Hiroyuki Enomoto Kensuke Kawai Rumiko Kan Shin-ichi Niwa Hirooki Yabe Yoshikazu Ugawa Quadripulse transcranial magnetic stimulation inducing long-term depression in healthy subjects may increase seizure risk in some patients with intractable epilepsy Clinical Neurophysiology Practice Quadripulse transcranial magnetic stimulation Intractable epilepsy Seizure Motor threshold |
| title | Quadripulse transcranial magnetic stimulation inducing long-term depression in healthy subjects may increase seizure risk in some patients with intractable epilepsy |
| title_full | Quadripulse transcranial magnetic stimulation inducing long-term depression in healthy subjects may increase seizure risk in some patients with intractable epilepsy |
| title_fullStr | Quadripulse transcranial magnetic stimulation inducing long-term depression in healthy subjects may increase seizure risk in some patients with intractable epilepsy |
| title_full_unstemmed | Quadripulse transcranial magnetic stimulation inducing long-term depression in healthy subjects may increase seizure risk in some patients with intractable epilepsy |
| title_short | Quadripulse transcranial magnetic stimulation inducing long-term depression in healthy subjects may increase seizure risk in some patients with intractable epilepsy |
| title_sort | quadripulse transcranial magnetic stimulation inducing long term depression in healthy subjects may increase seizure risk in some patients with intractable epilepsy |
| topic | Quadripulse transcranial magnetic stimulation Intractable epilepsy Seizure Motor threshold |
| url | http://www.sciencedirect.com/science/article/pii/S2467981X23000173 |
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