TITLE
Repetitive Transcranial Magnetic Stimulation for the Treatment of Refractory Epilepsy

AUTHORS
Carrette S; Boon P; Dekeyser C; Klooster DC; Carrette E; Meurs A; Raedt R; Baeken C; Vanhove C; Aldenkamp AP; Vonck K. Institution Carrette, Sofie. a Department of Neurology, Ghent University Hospital, Ghent, Belgium. Carrette, Sofie. b Laboratory for Clinical and Experimental Neurophysiology, Neurobiology and Neuropsychology (LCEN3), Ghent University, Ghent, Belgium. Boon, Paul. a Department of Neurology , Ghent University Hospital, Ghent, Belgium. Boon, Paul. b Laboratory for Clinical and Experimental Neurophysiology, Neurobiology and Neuropsychology (LCEN3), Ghent University, Ghent, Belgium. Boon, Paul. c Kempenhaeghe, Academic Center for Epileptology, Heeze, the Netherlands. Dekeyser, Catherine. a Department of Neurology, Ghent University Hospital, Ghent, Belgium. Dekeyser, Catherine. b Laboratory for Clinical and Experimental Neurophysiology, Neurobiology and Neuropsychology (LCEN3), Ghent University, Ghent, Belgium. Klooster, Debby C W. c Kempenhaeghe, Academic Center for Epileptology, Heeze, the Netherlands. Klooster, Debby C W. d Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands. Carrette, Evelien. a Department of Neurology, Ghent University Hospital, Ghent, Belgium. Carrette, Evelien. b Laboratory for Clinical and Experimental Neurophysiology, Neurobiology and Neuropsychology (LCEN3), Ghent University, Ghent, Belgium. Meurs, Alfred. a Department of Neurology, Ghent University Hospital, Ghent, Belgium. Meurs, Alfred. b Laboratory for Clinical and Experimental Neurophysiology, Neurobiology and Neuropsychology (LCEN3), Ghent University, Ghent, Belgium. Raedt, Robrecht. a Department of Neurology, Ghent University Hospital, Ghent, Belgium. Raedt, Robrecht. b Laboratory for Clinical and Experimental Neurophysiology, Neurobiology and Neuropsychology (LCEN3), Ghent University, Ghent, Belgium. Baeken, Chris. e Department of Psychiatry and Medical Psychology, Ghent University, Ghent, Belgium. Baeken, Chris. f Department of Psychiatry, University Hospital Brussels, Brussels, Belgium. Vanhove, Christian. g Department of Electronics and Information Systems, iMinds-IBiTech-MEDISIP, Ghent University, Ghent, Belgium. Aldenkamp, Albert P. a Department of Neurology, Ghent University Hospital, Ghent, Belgium. Aldenkamp, Albert P. c Kempenhaeghe, Academic Center for Epileptology, Heeze, the Netherlands. Aldenkamp, Albert P. d Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands. Aldenkamp, Albert P. h Department of Neurology, Maastricht University Medical Center, Maastricht, the Netherlands. Vonck, Kristl. a Department of Neurology, Ghent University Hospital, Ghent, Belgium. Vonck, Kristl. b Laboratory for Clinical and Experimental Neurophysiology, Neurobiology and Neuropsychology (LCEN3), Ghent University, Ghent, Belgium.

SOURCE
Expert Review of Neurotherapeutics. 16(9):1093-110, 2016 Sep.

ABSTRACT
Repetitive transcranial magnetic stimulation (rTMS) is an established non-invasive neurostimulation technique that is able to induce neuromodulatory effects outlasting the duration of the stimulation train. The cortical excitability disturbance in epilepsy provides a rationale for investigating the efficacy of low-frequency rTMS as a treatment for epilepsy patients. So far clinical trials in epilepsy patients have shown conflicting results ranging from ineffective to very effective.

AREAS COVERED
This manuscript provides an overview of the performed studies, retrieved from a PubMed search, and a critical appraisal of their results. A number of conclusions are drawn and potential optimization strategies are discussed.

EXPERT COMMENTARY
Although the therapeutic efficacy of rTMS in refractory epilepsy has not yet been established, the non-invasiveness of the technique warrants further investigation of rTMS as a treatment for epilepsy.