ID 152 - Paired pulse TMS-EMG and TMS-EEG in epilepsy

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• 作者：A.A. de Goede^a ; M.J.A.M. van Putten^a ; ^b
• 刊名：Clinical Neurophysiology
• 出版年：2016
• 出版时间：March 2016
• 年：2016
• 卷：127
• 期：3
• 页码：e81
• 全文大小：34 K

文摘

Epilepsy is characterized by an enduring predisposition to generate seizures, due to an increased cortical excitability (CE). Although the routine electroencephalogram (EEG) can assist in identifying increased CE, its sensitivity is low (30–55%). Therefore, we will investigate whether transcranial magnetic stimulation (TMS), another technique to measure CE, can be used to improve the diagnostic process in epilepsy.

Methods

Paired pulse TMS (ppTMS) is combined with electromyography (EMG) of the abductor pollicis brevis and 64-channel fullband EEG. Both motor hot spots are stimulated with 50 paired pulses (intensity 120% of resting motor threshold) at interstimulus intervals (ISIs): 50–300 ms, with 50 ms increments.

Results

ppTMS-EMG-EEG measurements on four healthy subjects are consistent with literature (Badawy et al. 2014; Premoli et al. 2014): ppTMS-EMG shows facilitation at ISI 50 ms and inhibition for ISIs 100–300 ms, while ppTMS-EEG (ISI 100 ms) shows inhibition below 70 ms and above 135 ms.

Conclusions

Based on pilot measures in healthy subjects, we will study first seizure patients to investigate differences in CE between patients diagnosed with epilepsy afterwards and those who are not. So far, ppTMS-EMG-EEG has never been applied in epilepsy.

Key message

ppTMS-EMG-EEG is a promising technique that may find application in the diagnostic process of epilepsy.