Article Sidebar
Main Article Content
Abstract
Transcranial Magnetic Stimulation (TMS) and Transcranial Direct Current Stimulation (tDCS) are new neurophysiological techniques that allow neurologists and neuroscientists to investigate brain function and neural networks in normal humans as well as in those with neurological and neuropsychiatric disorders.
In epilepsy, these techniques reveal abnormal excitability of the brain in focal and generalized epilepsy. Different patterns of excitatory and inhibitory changes detected by TMS have the potential to be used in the clinic for evaluating patients with epilepsy and to help with diagnosis, monitoring and treatment.
Repetitive TMS (rTMS) and tDCS have the ability to modulate cortical excitability over prolonged periods and are being trialled for the treatment of epilepsy. However, further studies are needed to find optimal stimulation paradigms that reliably reduce seizures, and to confirm long term benefits and safety of these interventions.
There are fewer TMS and tDCS studies in children and it's not clear if patterns of excitability changes are similar to those seen in adults or if there are unique patterns in childhood epilepsies. Continuing interventional trials assessing safety and efficacy of TMS and tDCS offer hope to children with treatment resistant epilepsies.
Keywords
Article Details
Copyright (c) 2016 Soumya Ghosh, Lakshmi Nagarajan
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Authors who publish with this journal agree to the following terms:
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).
References
1. Rossini PM, Rossi S (2007) Transcranial magnetic stimulation: diagnostic, therapeutic, and research potential. Neurology 68 (7):484-8. DOI: 10.1212/01. wnl.0000250268.13789.b2 PMID: 17296913
2. Nitsche MA, Cohen LG, Wassermann EM, Priori A, Lang N, Antal A et al. (2008) Transcranial direct current stimulation: State of the art 2008. Brain Stimul 1 (3):206-23. DOI: 10.1016/j.brs.2008.06.004 PMID: 20633386
3. Badawy RA, Strigaro G, Cantello R (2014) TMS, cortical excitability and epilepsy: the clinical impact. Epilepsy Res 108 (2):153-61. DOI: 10.1016/j.eplepsyres.2013.11.014 PMID: 24315665
4. Badawy RA, Macdonell RA, Berkovic SF, Newton MR, Jackson GD (2010) Predicting seizure control: cortical excitability and antiepileptic medication. Ann Neurol 67 (1):64-73. DOI: 10.1002/ana.21806 PMID: 20186859
5. Chen R, Cros D, Curra A, Di Lazzaro V, Lefaucheur JP, Magistris MR et al. (2008) The clinical diagnostic utility of transcranial magnetic stimulation: report of an IFCN committee. Clin Neurophysiol 119 (3):504-32. DOI: 10.1016/j.clinph.2007.10.014 PMID: 18063409
6. Vicario CM, Nitsche MA (2013) Non-invasive brain stimulation for the treatment of brain diseases in childhood and adolescence: state of the art, current limits and future challenges. Front Syst Neurosci 7 ():94. DOI: 10.3389/fnsys.2013.00094 PMID: 24324410
7. Frye RE, Rotenberg A, Ousley M, Pascual-Leone A (2008) Transcranial magnetic stimulation in child neurology: current and future directions. J Child Neurol 23 (1):79-96. DOI: 10.1177/0883073807307972 PMID: 18056688
8. Quintana H (2005) Transcranial magnetic stimulation in persons younger than the age of 18. J ECT 21 (2):88-95. PMID: 15905749
9. Cracco RQ, Cracco JB, Maccabee PJ, Amassian VE (1999) Cerebral function revealed by transcranial magnetic stimulation. J Neurosci Methods 86 (2):209-19. PMID: 10065987
10. Ghosh S, Mehta AR, Huang G, Gunraj C, Hoque T, Saha U et al. (2013) Short- and long-latency interhemispheric inhibitions are additive in human motor cortex. J Neurophysiol 109 (12):2955-62. DOI: 10.1152/jn.00960.2012 PMID: 23536711
11. Nitsche MA, Paulus W (2000) Excitability changes induced in the human motor cortex by weak transcranial direct current stimulation. J Physiol 527 Pt 3 ():633-9. PMID: 10990547
12. Batsikadze G, Moliadze V, Paulus W, Kuo MF, Nitsche MA (2013) Partially non-linear stimulation intensity-dependent effects of direct current stimulation on motor cortex excitability in humans. J Physiol 591 (7):1987- 2000. DOI: 10.1113/jphysiol.2012.249730 PMID: 23339180
13. Liebetanz D, Nitsche MA, Tergau F, Paulus W (2002) Pharmacological approach to the mechanisms of transcranial DC-stimulation-induced after-effects of human motor cortex excitability. Brain 125 (Pt 10):2238-47. PMID: 12244081
14. Nitsche MA, Liebetanz D, Schlitterlau A, Henschke U, Fricke K, Frommann K et al. (2004) GABAergic modulation of DC stimulation-induced motor cortex excitability shifts in humans. Eur J Neurosci 19 (10):2720-6. DOI: 10.1111/j.0953-816X.2004.03398.x PMID: 15147306
15. Lang N, Siebner HR, Ward NS, Lee L, Nitsche MA, Paulus W et al. (2005) How does transcranial DC stimulation of the primary motor cortex alter regional neuronal activity in the human brain? Eur J Neurosci 22 (2):495- 504. DOI: 10.1111/j.1460-9568.2005.04233.x PMID: 16045502
16. Stafstrom CE (2006) Epilepsy: a review of selected clinical syndromes and advances in basic science. J Cereb Blood Flow Metab 26 (8):983-1004. DOI: 10.1038/sj.jcbfm.9600265 PMID: 16437061
17. Brigo F, Storti M, Benedetti MD, Rossini F, Nardone R, Tezzon F et al. (2012) Resting motor threshold in idiopathic generalized epilepsies: a systematic review with meta-analysis. Epilepsy Res 101 (1-2):3-13. DOI: 10.1016/j.eplepsyres.2012.03.020 PMID: 22542570
18. Badawy RA, Curatolo JM, Newton M, Berkovic SF, Macdonell RA (2006) Sleep deprivation increases cortical excitability in epilepsy: syndrome-specific effects. Neurology 67 (6):1018-22. DOI: 10.1212/01. wnl.0000237392.64230.f7 PMID: 17000971
19. Theodore WH (2003) Transcranial Magnetic Stimulation in Epilepsy. Epilepsy Curr 3 (6):191-197. DOI: 10.1046/j.1535-7597.2003.03607.x PMID: 15346149
20. Kessler KR, Schnitzler A, Classen J, Benecke R (2002) Reduced inhibition within primary motor cortex in patients with poststroke focal motor seizures. Neurology 59 (7):1028-33. PMID: 12370457
21. Kujirai T, Caramia MD, Rothwell JC, Day BL, Thompson PD, Ferbert A et al. (1993) Corticocortical inhibition in human motor cortex. J Physiol 471 ():501-19. PMID: 8120818
22. Valls-Solé J, Pascual-Leone A, Wassermann EM, Hallett M (1992) Human motor evoked responses to paired transcranial magnetic stimuli. Electroencephalogr Clin Neurophysiol 85 (6):355-64. PMID: 1282453
23. Florian J, Müller-Dahlhaus M, Liu Y, Ziemann U (2008) Inhibitory circuits and the nature of their interactions in the human motor cortex a pharmacological TMS study. J Physiol 586 (2):495-514. DOI: 10.1113/jphysiol.2007.142059 PMID: 17991698
24. Ziemann U, Lönnecker S, Steinhoff BJ, Paulus W (1996) The effect of lorazepam on the motor cortical excitability in man. Exp Brain Res 109 (1):127-35. PMID: 8740215
25. Ziemann U (2003) Pharmacology of TMS. Suppl Clin Neurophysiol 56 ():226-31. PMID: 14677399
26. Smith MJ, Keel JC, Greenberg BD, Adams LF, Schmidt PJ, Rubinow DA et al. (1999) Menstrual cycle effects on cortical excitability. Neurology 53 (9):2069-72. PMID: 10599783
27. Aurora SK, Ahmad BK, Welch KM, Bhardhwaj P, Ramadan NM (1998) Transcranial magnetic stimulation confirms hyperexcitability of occipital cortex in migraine. Neurology 50 (4):1111-4. PMID: 9566403
28. Manganotti P, Bongiovanni LG, Zanette G, Fiaschi A (2000) Early and late intracortical inhibition in juvenile myoclonic epilepsy. Epilepsia 41 (9):1129-38. PMID: 10999552
29. Garvey MA, Gilbert DL (2004) Transcranial magnetic stimulation in children. Eur J Paediatr Neurol 8 (1):7-19. DOI: 10.1016/j.ejpn.2003.11.002 PMID: 15023371
30. Boroojerdi B, Kopylev L, Battaglia F, Facchini S, Ziemann U, Muellbacher W et al. (2000) Reproducibility of intracortical inhibition and facilitation using the paired- Ghosh S & Nagarajan L - JICNA 2016, 16:113 8 pulse paradigm. Muscle Nerve 23 (10):1594-7. PMID: 11003798
31. Reutens DC, Berkovic SF (1992) Increased cortical excitability in generalised epilepsy demonstrated with transcranial magnetic stimulation. Lancet 339 (8789):362-3. PMID: 1346432
32. Reutens DC, Puce A, Berkovic SF (1993) Cortical hyperexcitability in progressive myoclonus epilepsy: a study with transcranial magnetic stimulation. Neurology 43 (1):186-92. PMID: 8423883
33. Badawy RA, Jackson GD, Berkovic SF, Macdonell RA (2013) Cortical excitability and refractory epilepsy: a three-year longitudinal transcranial magnetic stimulation study. Int J Neural Syst 23 (1):1250030. DOI: 10.1142/ S012906571250030X PMID: 23273126
34. Badawy RA, Vogrin SJ, Lai A, Cook MJ (2013) Patterns of cortical hyperexcitability in adolescent/adult-onset generalized epilepsies. Epilepsia 54 (5):871-8. DOI: 10.1111/epi.12151 PMID: 23551088
35. Gianelli M, Cantello R, Civardi C, Naldi P, Bettucci D, Schiavella MP et al. (1994) Idiopathic generalized epilepsy: magnetic stimulation of motor cortex time-locked and unlocked to 3-Hz spike-and-wave discharges. Epilepsia 35 (1):53-60. PMID: 8112258
36. Caramia MD, Gigli G, Iani C, Desiato MT, Diomedi M, Palmieri MG et al. (1996) Distinguishing forms of generalized epilepsy using magnetic brain stimulation. Electroencephalogr Clin Neurophysiol 98 (1):14-9. PMID: 8689988
37. Brodtmann A, Macdonell RA, Gilligan AK, Curatolo J, Berkovic SF (1999) Cortical excitability and recovery curve analysis in generalized epilepsy. Neurology 53 (6):1347-9. PMID: 10522899
38. Badawy RA, Curatolo JM, Newton M, Berkovic SF, Macdonell RA (2007) Changes in cortical excitability differentiate generalized and focal epilepsy. Ann Neurol 61 (4):324-31. DOI: 10.1002/ana.21087 PMID: 17358004
39. Kotova OV, Vorob’eva OV (2007) Evoked motor response thresholds during transcranial magnetic stimulation in patients with symptomatic partial epilepsy. Neurosci Behav Physiol 37 (9):849-52. DOI: 10.1007/ s11055-007-0091-7 PMID: 17955376
40. Cicinelli P, Mattia D, Spanedda F, Traversa R, Marciani MG, Pasqualetti P et al. (2000) Transcranial magnetic stimulation reveals an interhemispheric asymmetry of cortical inhibition in focal epilepsy. Neuroreport 11 (4):701-7. PMID: 10757504
41. Cantello R, Civardi C, Cavalli A, Varrasi C, Tarletti R, Monaco F et al. (2000) Cortical excitability in cryptogenic localization-related epilepsy: interictal transcranial magnetic stimulation studies. Epilepsia 41 (6):694-704. PMID: 10840401
42. Hamer HM, Reis J, Mueller HH, Knake S, Overhof M, Oertel WH et al. (2005) Motor cortex excitability in focal epilepsies not including the primary motor area--a TMS study. Brain 128 (Pt 4):811-8. DOI: 10.1093/brain/ awh398 PMID: 15728658
43. Badawy RA, Macdonell RA, Vogrin SJ, Lai A, Cook MJ (2012) Cortical excitability decreases in Lennox-Gastaut syndrome. Epilepsia 53 (9):1546-53. DOI: 10.1111/j.1528-1167.2012.03599.x PMID: 22813348
44. Nezu A, Kimura S, Ohtsuki N, Tanaka M (1997) Transcranial magnetic stimulation in benign childhood epilepsy with centro-temporal spikes. Brain Dev 19 (2):134-7. PMID: 9105661
45. Inghilleri M, Mattia D, Berardelli A, Manfredi M (1998) Asymmetry of cortical excitability revealed by transcranial stimulation in a patient with focal motor epilepsy and cortical myoclonus. Electroencephalogr Clin Neurophysiol 109 (1):70-2. PMID: 11003066
46. Shimizu T, Maehara T, Hino T, Komori T, Shimizu H, Yagishita A et al. (2001) Effect of multiple subpial transection on motor cortical excitability in cortical dysgenesis. Brain 124 (Pt 7):1336-49. PMID: 11408329
47. Menkes DL, Gruenthal M (2000) Slow-frequency repetitive transcranial magnetic stimulation in a patient with focal cortical dysplasia. Epilepsia 41 (2):240-2. PMID: 10691123
48. Misawa S, Kuwabara S, Shibuya K, Mamada K, Hattori T (2005) Low-frequency transcranial magnetic stimulation for epilepsia partialis continua due to cortical dysplasia. J Neurol Sci 234 (1-2):37-9. DOI: 10.1016/j. jns.2005.03.035 PMID: 15946689
49. Brasil-Neto JP, de Araújo DP, Teixeira WA, Araújo VP, Boechat-Barros R (2004) Experimental therapy of epilepsy with transcranial magnetic stimulation: lack of additional benefit with prolonged treatment. Arq Neuropsiquiatr 62 (1):21-5. PMID: 15122428
50. Fregni F, Thome-Souza S, Bermpohl F, Marcolin MA, Herzog A, Pascual-Leone A et al. (2005) Antiepileptic effects of repetitive transcranial magnetic stimulation in patients with cortical malformations: an EEG and clinical study. Stereotact Funct Neurosurg 83 (2-3):57-62. DOI: 10.1159/000086674 PMID: 15990468
51. Santiago-Rodríguez E, Cárdenas-Morales L, Harmony T, Fernández-Bouzas A, Porras-Kattz E, Hernández A (2008) Repetitive transcranial magnetic stimulation decreases the number of seizures in patients with focal neocortical epilepsy. Seizure 17 (8):677-83. DOI: 10.1016/j.seizure.2008.04.005 PMID: 18495500
52. Sun W, Mao W, Meng X, Wang D, Qiao L, Tao W et al. (2012) Low-frequency repetitive transcranial magnetic stimulation for the treatment of refractory partial epilepsy: a controlled clinical study. Epilepsia 53 (10):1782- 9. DOI: 10.1111/j.1528-1167.2012.03626.x PMID: 22950513
53. Kinoshita M, Ikeda A, Begum T, Yamamoto J, Hitomi T, Shibasaki H (2005) Low-frequency repetitive transcranial magnetic stimulation for seizure suppression in patients with extratemporal lobe epilepsy-a pilot study. Seizure 14 (6):387-92. DOI: 10.1016/j.seizure.2005.05.002 PMID: 16046153
54. Joo EY, Han SJ, Chung SH, Cho JW, Seo DW, Hong SB (2007) Antiepileptic effects of low-frequency repetitive transcranial magnetic stimulation by different stimulation durations and locations. Clin Neurophysiol 118 (3):702-8. DOI: 10.1016/j.clinph.2006.11.008 PMID: 17223384
55. Fregni F, Otachi PT, Do Valle A, Boggio PS, Thut G, Rigonatti SP et al. (2006) A randomized clinical trial of repetitive transcranial magnetic stimulation in patients with refractory epilepsy. Ann Neurol 60 (4):447-55. DOI: 10.1002/ana.20950 PMID: 17068786
56. Cantello R, Rossi S, Varrasi C, Ulivelli M, Civardi C, Bartalini S et al. (2007) Slow repetitive TMS for drug-resistant epilepsy: clinical and EEG findings of a placebo-controlled trial. Epilepsia 48 (2):366-74. DOI: 10.1111/j.1528-1167.2006.00938.x PMID: 17295632
57. Morales OG, Henry ME, Nobler MS, Wassermann EM, Lisanby SH (2005) Electroconvulsive therapy and repetitive transcranial magnetic stimulation in children and adolescents: a review and report of two cases of epilepsia partialis continua. Child Adolesc Psychiatr Clin N Am 14 (1):193-210, viii-ix. DOI: 10.1016/j.chc.2004.07.010 PMID: 15564059
58. Graff-Guerrero A, Gonzáles-Olvera J, Ruiz-García M, Avila-Ordoñez U, Vaugier V, García-Reyna JC (2004) rTMS reduces focal brain hyperperfusion in two patients with EPC. Acta Neurol Scand 109 (4):290-6. PMID: 15016013
59. Wiethoff S, Hamada M, Rothwell JC (2014) Variability in response to transcranial direct current stimulation of the motor cortex. Brain Stimul 7 (3):468-75. DOI: 10.1016/j. brs.2014.02.003 PMID: 24630848
60. Yook SW, Park SH, Seo JH, Kim SJ, Ko MH (2011) Suppression of seizure by cathodal transcranial direct current stimulation in an epileptic patient - a case report -. Ann Rehabil Med 35 (4):579-82. DOI: 10.5535/ arm.2011.35.4.579 PMID: 22506177
61. Nagarajan L, Mitrovic C, Ghosh S: Transcranial direct current stimulation (tDCS) in refractory epilepsy: case report. (abstract) Epilepsy (P98). JICNA, [S.l.], May. 2014. doi:http://dx.doi.org/10.17724/jicna.2014.s1.pos5
62. Auvichayapat N, Rotenberg A, Gersner R, Ngodklang S, Tiamkao S, Tassaneeyakul W et al. (2013) Transcranial direct current stimulation for treatment of refractory childhood focal epilepsy. Brain Stimul 6 (4):696-700. DOI: 10.1016/j.brs.2013.01.009 PMID: 23415937
63. Varga ET, Terney D, Atkins MD, Nikanorova M, Jeppesen DS, Uldall P et al. (2011) Transcranial direct current stimulation in refractory continuous spikes and waves during slow sleep: a controlled study. Epilepsy Res 97 (1-2):142-5. DOI: 10.1016/j.eplepsyres.2011.07.016 PMID: 21885255
64. Vicario CM, Nitsche MA (2013) Transcranial direct current stimulation: a remediation tool for the treatment of childhood congenital dyslexia? Front Hum Neurosci 7 ():139. DOI: 10.3389/fnhum.2013.00139 PMID: 23626530
65. Cohen Kadosh R, Levy N, O’Shea J, Shea N, Savulescu J (2012) The neuroethics of non-invasive brain stimulation. Curr Biol 22 (4):R108-11. DOI: 10.1016/j. cub.2012.01.013 PMID: 22361141
66. Bae EH, Schrader LM, Machii K, Alonso-Alonso M, Riviello JJ, Pascual-Leone A et al. (2007) Safety and tolerability of repetitive transcranial magnetic stimulation in patients with epilepsy: a review of the literature. Epilepsy Behav 10 (4):521-8. DOI: 10.1016/j.yebeh.2007.03.004 PMID: 17493877
67. Rossi S, Hallett M, Rossini PM, Pascual-Leone A, Safety of TMS Consensus Group (2009) Safety, ethical considerations, and application guidelines for the use of transcranial magnetic stimulation in clinical practice and research. Clin Neurophysiol 120 (12):2008-39. DOI: 10.1016/j.clinph.2009.08.016 PMID: 19833552
68. Arul-Anandam AP, Loo C, Sachdev P: Transcranial direct current stimulation - what is the evidence for its efficacy and safety? F1000 Medicine Reports 2009, I:58 (doi:10.3410/MI-58)
69. Nitsche MA, Liebetanz D, Lang N, Antal A, Tergau F, Paulus W (2003) Safety criteria for transcranial direct current stimulation (tDCS) in humans. Clin Neurophysiol 114 (11):2220-2; author reply 2222-3. PMID: 14580622.
70. Dayan E, Censor N, Buch ER, Sandrini M, Cohen LG (2013) Noninvasive brain stimulation: from physiology to network dynamics and back. Nat Neurosci 16 (7):838- 44. DOI: 10.1038/nn.3422 PMID:23799477
References
1. Rossini PM, Rossi S (2007) Transcranial magnetic stimulation: diagnostic, therapeutic, and research potential. Neurology 68 (7):484-8. DOI: 10.1212/01. wnl.0000250268.13789.b2 PMID: 17296913
2. Nitsche MA, Cohen LG, Wassermann EM, Priori A, Lang N, Antal A et al. (2008) Transcranial direct current stimulation: State of the art 2008. Brain Stimul 1 (3):206-23. DOI: 10.1016/j.brs.2008.06.004 PMID: 20633386
3. Badawy RA, Strigaro G, Cantello R (2014) TMS, cortical excitability and epilepsy: the clinical impact. Epilepsy Res 108 (2):153-61. DOI: 10.1016/j.eplepsyres.2013.11.014 PMID: 24315665
4. Badawy RA, Macdonell RA, Berkovic SF, Newton MR, Jackson GD (2010) Predicting seizure control: cortical excitability and antiepileptic medication. Ann Neurol 67 (1):64-73. DOI: 10.1002/ana.21806 PMID: 20186859
5. Chen R, Cros D, Curra A, Di Lazzaro V, Lefaucheur JP, Magistris MR et al. (2008) The clinical diagnostic utility of transcranial magnetic stimulation: report of an IFCN committee. Clin Neurophysiol 119 (3):504-32. DOI: 10.1016/j.clinph.2007.10.014 PMID: 18063409
6. Vicario CM, Nitsche MA (2013) Non-invasive brain stimulation for the treatment of brain diseases in childhood and adolescence: state of the art, current limits and future challenges. Front Syst Neurosci 7 ():94. DOI: 10.3389/fnsys.2013.00094 PMID: 24324410
7. Frye RE, Rotenberg A, Ousley M, Pascual-Leone A (2008) Transcranial magnetic stimulation in child neurology: current and future directions. J Child Neurol 23 (1):79-96. DOI: 10.1177/0883073807307972 PMID: 18056688
8. Quintana H (2005) Transcranial magnetic stimulation in persons younger than the age of 18. J ECT 21 (2):88-95. PMID: 15905749
9. Cracco RQ, Cracco JB, Maccabee PJ, Amassian VE (1999) Cerebral function revealed by transcranial magnetic stimulation. J Neurosci Methods 86 (2):209-19. PMID: 10065987
10. Ghosh S, Mehta AR, Huang G, Gunraj C, Hoque T, Saha U et al. (2013) Short- and long-latency interhemispheric inhibitions are additive in human motor cortex. J Neurophysiol 109 (12):2955-62. DOI: 10.1152/jn.00960.2012 PMID: 23536711
11. Nitsche MA, Paulus W (2000) Excitability changes induced in the human motor cortex by weak transcranial direct current stimulation. J Physiol 527 Pt 3 ():633-9. PMID: 10990547
12. Batsikadze G, Moliadze V, Paulus W, Kuo MF, Nitsche MA (2013) Partially non-linear stimulation intensity-dependent effects of direct current stimulation on motor cortex excitability in humans. J Physiol 591 (7):1987- 2000. DOI: 10.1113/jphysiol.2012.249730 PMID: 23339180
13. Liebetanz D, Nitsche MA, Tergau F, Paulus W (2002) Pharmacological approach to the mechanisms of transcranial DC-stimulation-induced after-effects of human motor cortex excitability. Brain 125 (Pt 10):2238-47. PMID: 12244081
14. Nitsche MA, Liebetanz D, Schlitterlau A, Henschke U, Fricke K, Frommann K et al. (2004) GABAergic modulation of DC stimulation-induced motor cortex excitability shifts in humans. Eur J Neurosci 19 (10):2720-6. DOI: 10.1111/j.0953-816X.2004.03398.x PMID: 15147306
15. Lang N, Siebner HR, Ward NS, Lee L, Nitsche MA, Paulus W et al. (2005) How does transcranial DC stimulation of the primary motor cortex alter regional neuronal activity in the human brain? Eur J Neurosci 22 (2):495- 504. DOI: 10.1111/j.1460-9568.2005.04233.x PMID: 16045502
16. Stafstrom CE (2006) Epilepsy: a review of selected clinical syndromes and advances in basic science. J Cereb Blood Flow Metab 26 (8):983-1004. DOI: 10.1038/sj.jcbfm.9600265 PMID: 16437061
17. Brigo F, Storti M, Benedetti MD, Rossini F, Nardone R, Tezzon F et al. (2012) Resting motor threshold in idiopathic generalized epilepsies: a systematic review with meta-analysis. Epilepsy Res 101 (1-2):3-13. DOI: 10.1016/j.eplepsyres.2012.03.020 PMID: 22542570
18. Badawy RA, Curatolo JM, Newton M, Berkovic SF, Macdonell RA (2006) Sleep deprivation increases cortical excitability in epilepsy: syndrome-specific effects. Neurology 67 (6):1018-22. DOI: 10.1212/01. wnl.0000237392.64230.f7 PMID: 17000971
19. Theodore WH (2003) Transcranial Magnetic Stimulation in Epilepsy. Epilepsy Curr 3 (6):191-197. DOI: 10.1046/j.1535-7597.2003.03607.x PMID: 15346149
20. Kessler KR, Schnitzler A, Classen J, Benecke R (2002) Reduced inhibition within primary motor cortex in patients with poststroke focal motor seizures. Neurology 59 (7):1028-33. PMID: 12370457
21. Kujirai T, Caramia MD, Rothwell JC, Day BL, Thompson PD, Ferbert A et al. (1993) Corticocortical inhibition in human motor cortex. J Physiol 471 ():501-19. PMID: 8120818
22. Valls-Solé J, Pascual-Leone A, Wassermann EM, Hallett M (1992) Human motor evoked responses to paired transcranial magnetic stimuli. Electroencephalogr Clin Neurophysiol 85 (6):355-64. PMID: 1282453
23. Florian J, Müller-Dahlhaus M, Liu Y, Ziemann U (2008) Inhibitory circuits and the nature of their interactions in the human motor cortex a pharmacological TMS study. J Physiol 586 (2):495-514. DOI: 10.1113/jphysiol.2007.142059 PMID: 17991698
24. Ziemann U, Lönnecker S, Steinhoff BJ, Paulus W (1996) The effect of lorazepam on the motor cortical excitability in man. Exp Brain Res 109 (1):127-35. PMID: 8740215
25. Ziemann U (2003) Pharmacology of TMS. Suppl Clin Neurophysiol 56 ():226-31. PMID: 14677399
26. Smith MJ, Keel JC, Greenberg BD, Adams LF, Schmidt PJ, Rubinow DA et al. (1999) Menstrual cycle effects on cortical excitability. Neurology 53 (9):2069-72. PMID: 10599783
27. Aurora SK, Ahmad BK, Welch KM, Bhardhwaj P, Ramadan NM (1998) Transcranial magnetic stimulation confirms hyperexcitability of occipital cortex in migraine. Neurology 50 (4):1111-4. PMID: 9566403
28. Manganotti P, Bongiovanni LG, Zanette G, Fiaschi A (2000) Early and late intracortical inhibition in juvenile myoclonic epilepsy. Epilepsia 41 (9):1129-38. PMID: 10999552
29. Garvey MA, Gilbert DL (2004) Transcranial magnetic stimulation in children. Eur J Paediatr Neurol 8 (1):7-19. DOI: 10.1016/j.ejpn.2003.11.002 PMID: 15023371
30. Boroojerdi B, Kopylev L, Battaglia F, Facchini S, Ziemann U, Muellbacher W et al. (2000) Reproducibility of intracortical inhibition and facilitation using the paired- Ghosh S & Nagarajan L - JICNA 2016, 16:113 8 pulse paradigm. Muscle Nerve 23 (10):1594-7. PMID: 11003798
31. Reutens DC, Berkovic SF (1992) Increased cortical excitability in generalised epilepsy demonstrated with transcranial magnetic stimulation. Lancet 339 (8789):362-3. PMID: 1346432
32. Reutens DC, Puce A, Berkovic SF (1993) Cortical hyperexcitability in progressive myoclonus epilepsy: a study with transcranial magnetic stimulation. Neurology 43 (1):186-92. PMID: 8423883
33. Badawy RA, Jackson GD, Berkovic SF, Macdonell RA (2013) Cortical excitability and refractory epilepsy: a three-year longitudinal transcranial magnetic stimulation study. Int J Neural Syst 23 (1):1250030. DOI: 10.1142/ S012906571250030X PMID: 23273126
34. Badawy RA, Vogrin SJ, Lai A, Cook MJ (2013) Patterns of cortical hyperexcitability in adolescent/adult-onset generalized epilepsies. Epilepsia 54 (5):871-8. DOI: 10.1111/epi.12151 PMID: 23551088
35. Gianelli M, Cantello R, Civardi C, Naldi P, Bettucci D, Schiavella MP et al. (1994) Idiopathic generalized epilepsy: magnetic stimulation of motor cortex time-locked and unlocked to 3-Hz spike-and-wave discharges. Epilepsia 35 (1):53-60. PMID: 8112258
36. Caramia MD, Gigli G, Iani C, Desiato MT, Diomedi M, Palmieri MG et al. (1996) Distinguishing forms of generalized epilepsy using magnetic brain stimulation. Electroencephalogr Clin Neurophysiol 98 (1):14-9. PMID: 8689988
37. Brodtmann A, Macdonell RA, Gilligan AK, Curatolo J, Berkovic SF (1999) Cortical excitability and recovery curve analysis in generalized epilepsy. Neurology 53 (6):1347-9. PMID: 10522899
38. Badawy RA, Curatolo JM, Newton M, Berkovic SF, Macdonell RA (2007) Changes in cortical excitability differentiate generalized and focal epilepsy. Ann Neurol 61 (4):324-31. DOI: 10.1002/ana.21087 PMID: 17358004
39. Kotova OV, Vorob’eva OV (2007) Evoked motor response thresholds during transcranial magnetic stimulation in patients with symptomatic partial epilepsy. Neurosci Behav Physiol 37 (9):849-52. DOI: 10.1007/ s11055-007-0091-7 PMID: 17955376
40. Cicinelli P, Mattia D, Spanedda F, Traversa R, Marciani MG, Pasqualetti P et al. (2000) Transcranial magnetic stimulation reveals an interhemispheric asymmetry of cortical inhibition in focal epilepsy. Neuroreport 11 (4):701-7. PMID: 10757504
41. Cantello R, Civardi C, Cavalli A, Varrasi C, Tarletti R, Monaco F et al. (2000) Cortical excitability in cryptogenic localization-related epilepsy: interictal transcranial magnetic stimulation studies. Epilepsia 41 (6):694-704. PMID: 10840401
42. Hamer HM, Reis J, Mueller HH, Knake S, Overhof M, Oertel WH et al. (2005) Motor cortex excitability in focal epilepsies not including the primary motor area--a TMS study. Brain 128 (Pt 4):811-8. DOI: 10.1093/brain/ awh398 PMID: 15728658
43. Badawy RA, Macdonell RA, Vogrin SJ, Lai A, Cook MJ (2012) Cortical excitability decreases in Lennox-Gastaut syndrome. Epilepsia 53 (9):1546-53. DOI: 10.1111/j.1528-1167.2012.03599.x PMID: 22813348
44. Nezu A, Kimura S, Ohtsuki N, Tanaka M (1997) Transcranial magnetic stimulation in benign childhood epilepsy with centro-temporal spikes. Brain Dev 19 (2):134-7. PMID: 9105661
45. Inghilleri M, Mattia D, Berardelli A, Manfredi M (1998) Asymmetry of cortical excitability revealed by transcranial stimulation in a patient with focal motor epilepsy and cortical myoclonus. Electroencephalogr Clin Neurophysiol 109 (1):70-2. PMID: 11003066
46. Shimizu T, Maehara T, Hino T, Komori T, Shimizu H, Yagishita A et al. (2001) Effect of multiple subpial transection on motor cortical excitability in cortical dysgenesis. Brain 124 (Pt 7):1336-49. PMID: 11408329
47. Menkes DL, Gruenthal M (2000) Slow-frequency repetitive transcranial magnetic stimulation in a patient with focal cortical dysplasia. Epilepsia 41 (2):240-2. PMID: 10691123
48. Misawa S, Kuwabara S, Shibuya K, Mamada K, Hattori T (2005) Low-frequency transcranial magnetic stimulation for epilepsia partialis continua due to cortical dysplasia. J Neurol Sci 234 (1-2):37-9. DOI: 10.1016/j. jns.2005.03.035 PMID: 15946689
49. Brasil-Neto JP, de Araújo DP, Teixeira WA, Araújo VP, Boechat-Barros R (2004) Experimental therapy of epilepsy with transcranial magnetic stimulation: lack of additional benefit with prolonged treatment. Arq Neuropsiquiatr 62 (1):21-5. PMID: 15122428
50. Fregni F, Thome-Souza S, Bermpohl F, Marcolin MA, Herzog A, Pascual-Leone A et al. (2005) Antiepileptic effects of repetitive transcranial magnetic stimulation in patients with cortical malformations: an EEG and clinical study. Stereotact Funct Neurosurg 83 (2-3):57-62. DOI: 10.1159/000086674 PMID: 15990468
51. Santiago-Rodríguez E, Cárdenas-Morales L, Harmony T, Fernández-Bouzas A, Porras-Kattz E, Hernández A (2008) Repetitive transcranial magnetic stimulation decreases the number of seizures in patients with focal neocortical epilepsy. Seizure 17 (8):677-83. DOI: 10.1016/j.seizure.2008.04.005 PMID: 18495500
52. Sun W, Mao W, Meng X, Wang D, Qiao L, Tao W et al. (2012) Low-frequency repetitive transcranial magnetic stimulation for the treatment of refractory partial epilepsy: a controlled clinical study. Epilepsia 53 (10):1782- 9. DOI: 10.1111/j.1528-1167.2012.03626.x PMID: 22950513
53. Kinoshita M, Ikeda A, Begum T, Yamamoto J, Hitomi T, Shibasaki H (2005) Low-frequency repetitive transcranial magnetic stimulation for seizure suppression in patients with extratemporal lobe epilepsy-a pilot study. Seizure 14 (6):387-92. DOI: 10.1016/j.seizure.2005.05.002 PMID: 16046153
54. Joo EY, Han SJ, Chung SH, Cho JW, Seo DW, Hong SB (2007) Antiepileptic effects of low-frequency repetitive transcranial magnetic stimulation by different stimulation durations and locations. Clin Neurophysiol 118 (3):702-8. DOI: 10.1016/j.clinph.2006.11.008 PMID: 17223384
55. Fregni F, Otachi PT, Do Valle A, Boggio PS, Thut G, Rigonatti SP et al. (2006) A randomized clinical trial of repetitive transcranial magnetic stimulation in patients with refractory epilepsy. Ann Neurol 60 (4):447-55. DOI: 10.1002/ana.20950 PMID: 17068786
56. Cantello R, Rossi S, Varrasi C, Ulivelli M, Civardi C, Bartalini S et al. (2007) Slow repetitive TMS for drug-resistant epilepsy: clinical and EEG findings of a placebo-controlled trial. Epilepsia 48 (2):366-74. DOI: 10.1111/j.1528-1167.2006.00938.x PMID: 17295632
57. Morales OG, Henry ME, Nobler MS, Wassermann EM, Lisanby SH (2005) Electroconvulsive therapy and repetitive transcranial magnetic stimulation in children and adolescents: a review and report of two cases of epilepsia partialis continua. Child Adolesc Psychiatr Clin N Am 14 (1):193-210, viii-ix. DOI: 10.1016/j.chc.2004.07.010 PMID: 15564059
58. Graff-Guerrero A, Gonzáles-Olvera J, Ruiz-García M, Avila-Ordoñez U, Vaugier V, García-Reyna JC (2004) rTMS reduces focal brain hyperperfusion in two patients with EPC. Acta Neurol Scand 109 (4):290-6. PMID: 15016013
59. Wiethoff S, Hamada M, Rothwell JC (2014) Variability in response to transcranial direct current stimulation of the motor cortex. Brain Stimul 7 (3):468-75. DOI: 10.1016/j. brs.2014.02.003 PMID: 24630848
60. Yook SW, Park SH, Seo JH, Kim SJ, Ko MH (2011) Suppression of seizure by cathodal transcranial direct current stimulation in an epileptic patient - a case report -. Ann Rehabil Med 35 (4):579-82. DOI: 10.5535/ arm.2011.35.4.579 PMID: 22506177
61. Nagarajan L, Mitrovic C, Ghosh S: Transcranial direct current stimulation (tDCS) in refractory epilepsy: case report. (abstract) Epilepsy (P98). JICNA, [S.l.], May. 2014. doi:http://dx.doi.org/10.17724/jicna.2014.s1.pos5
62. Auvichayapat N, Rotenberg A, Gersner R, Ngodklang S, Tiamkao S, Tassaneeyakul W et al. (2013) Transcranial direct current stimulation for treatment of refractory childhood focal epilepsy. Brain Stimul 6 (4):696-700. DOI: 10.1016/j.brs.2013.01.009 PMID: 23415937
63. Varga ET, Terney D, Atkins MD, Nikanorova M, Jeppesen DS, Uldall P et al. (2011) Transcranial direct current stimulation in refractory continuous spikes and waves during slow sleep: a controlled study. Epilepsy Res 97 (1-2):142-5. DOI: 10.1016/j.eplepsyres.2011.07.016 PMID: 21885255
64. Vicario CM, Nitsche MA (2013) Transcranial direct current stimulation: a remediation tool for the treatment of childhood congenital dyslexia? Front Hum Neurosci 7 ():139. DOI: 10.3389/fnhum.2013.00139 PMID: 23626530
65. Cohen Kadosh R, Levy N, O’Shea J, Shea N, Savulescu J (2012) The neuroethics of non-invasive brain stimulation. Curr Biol 22 (4):R108-11. DOI: 10.1016/j. cub.2012.01.013 PMID: 22361141
66. Bae EH, Schrader LM, Machii K, Alonso-Alonso M, Riviello JJ, Pascual-Leone A et al. (2007) Safety and tolerability of repetitive transcranial magnetic stimulation in patients with epilepsy: a review of the literature. Epilepsy Behav 10 (4):521-8. DOI: 10.1016/j.yebeh.2007.03.004 PMID: 17493877
67. Rossi S, Hallett M, Rossini PM, Pascual-Leone A, Safety of TMS Consensus Group (2009) Safety, ethical considerations, and application guidelines for the use of transcranial magnetic stimulation in clinical practice and research. Clin Neurophysiol 120 (12):2008-39. DOI: 10.1016/j.clinph.2009.08.016 PMID: 19833552
68. Arul-Anandam AP, Loo C, Sachdev P: Transcranial direct current stimulation - what is the evidence for its efficacy and safety? F1000 Medicine Reports 2009, I:58 (doi:10.3410/MI-58)
69. Nitsche MA, Liebetanz D, Lang N, Antal A, Tergau F, Paulus W (2003) Safety criteria for transcranial direct current stimulation (tDCS) in humans. Clin Neurophysiol 114 (11):2220-2; author reply 2222-3. PMID: 14580622.
70. Dayan E, Censor N, Buch ER, Sandrini M, Cohen LG (2013) Noninvasive brain stimulation: from physiology to network dynamics and back. Nat Neurosci 16 (7):838- 44. DOI: 10.1038/nn.3422 PMID:23799477