Epileptic seizure typically originate from an epileptic focus, which is a hyperexcitable region of brain cortex. An interesting treatment may be inhibitory (<1Hz) repetitive transcranial magnetic stimulation (rTMS) to tune down local excitability. Theta burst stimulation (TBS) is a relatively novel and potent rTMS protocol holding multiple advantages concerning practicality and durability of the induced effects. This is the first study applying cTBS in the context of epilepsy.
In this study, 10 patients with neocortical epilepsy will be treated with cTBS, directed towards the seizure focus. The primary goal is to test the safety and tolerability of cTBS in epilepsy. Therefore, we will perform neuropsychological tests and we keep track of seizure occurrence and other adverse events during the stimulation treatment. Furthermore we are interested in the clinical efficacy. To test this, patients are asked to keep a seizure diary and we record EEG.
The secondary goal is to study the mechanism of action of TMS. Before and after the treatment, we test cortical excitability using TMS-EMG and TMS-EEG and we want to study brain connectivities based on high density EEG recordings and MRI (anatomical, functional, and diffusion scans). In other words, we are interested whether locally applied TMS improves the overall organization of the brain network.