Hi,

Neurology

April 05, 2016; 86 (16 Supplement) APRIL 20, 2016

rTMS Induces Changes in FDG Brain Metabolism in Patients with Epilepsy (P5.010) Laura Seynaeve, Bliede Van den Broeck, Patrick Dupont, Karolien Goffin, Wim Van Paesschen

First published April 4, 2016,

Abstract

OBJECTIVE:To determine the effect of repetitive transcranial magnetic stimulation (rTMS) on brain metabolism and seizure frequency. BACKGROUND:Low-frequency rTMS targeted to the epileptic focus may reduce seizure frequency. We hypothesized that changes in brain metabolism, which have been observed in healthy controls after rTMS, could be a biomarker of the anti-epileptic activity of rTMS. METHODS:We performed a double-blind, sham controlled, cross-over trial of targeted 0.5 Hz rTMS over the epileptic focus in 11 patients with well-characterized neocortical epilepsy using a round coil, figure-8 coil or sham coil. Before the first treatment and in the week following each rTMS session, an FDG-PET was acquired dynamically for 60 minutes following an injection of 74±4.7MBq FDG. Post-treatment scans were compared to baseline in individual patients. A region of interest (ROI) was defined as a sphere with a 1 cm radius around the target of stimulation. RESULTS:Increased metabolism (z-score≥2) in this ROI was seen in 1/9, 3/10 and 0/9 patients after figure-8, round or sham coil treatment, respectively, and decreased metabolism (z-score≤-2) in 4/9, 3/10 and 3/9. A pattern of decreased metabolism was variably present and did not correlate with active or sham treatment in individual patients. Increased metabolism was seen after active treatment in two patients, both with a partial resection of their epileptogenic region. rTMS was on average not effective in reducing seizure frequency. No difference in effectiveness between the different coil-types was observed. We observed seizures exacerbation during treatment in one patient and a rebound in seizure frequency after an initial reduction in a second patient. PET metabolic changes were not predictive of seizure outcome. CONCLUSIONS: FDG-PET showed a variable response in changes in metabolism in the region of stimulation following rTMS for refractory epilepsy and this was not predictive of seizure outcome. Study Supported by the Agency for Inovation by Science&Technology

Hi Bhogaraju Anand. thanks for your attention. but i need full article, because i want to enter it in my systematic review.

thank a lot

Hi,

It looks like a conference abstract and I don't think a full-length article is published. You may contact the authors.

thanks