Reduction of cortical myoclonus-related epileptic activity following slow-frequency rTMS.
In a drug-resistant epilepsy patient with continuous forearm/hand positive myoclonia due to a focal cortical dysplasia of the right motor cortex, cortical jerk-related and electromyographic activity were recorded for 15 min before and after 1 Hz rTMS (15 min, 10% below the resting excitability threshold) of the right motor cortex. A stable negative cortical spike, time-locked with contralateral muscle jerks (60 > 100 microV), was detected only at perirolandic electrodes (maximal amplitudes: block 1 = 21.3 microV, block 2 = 22 microV, block 3 = 25.9 microV). After rTMS, only 20 muscle jerks accomplished the criterion of > 100 microV; blind back-averaging of these disclosed a topographically similar cortical spike, but with amplitude reduced by at least 50% (11.2 microV). This represents in vivo evidence of the possibility to selectively modulate the activity of an epileptic focus by intervening with local low-frequency rTMS.
Rossi
Simone
S
Dipartimento di Neuroscienze, Sezione Neurologia, Università di Siena, Policlinico Le Scotte, Viale Bracci I-53100, Italy. Rossimo@unisi.it
Ulivelli
Monica
M
Bartalini
Sabina
S
Galli
Rosita
R
Passero
Stefano
S
Battistini
Noè
N
Vatti
Giampaolo
G
D000200:Action Potentials / Q000502:physiology; D000328:Adult; D001931:Brain Mapping; D004599:Electric Stimulation Therapy / Q000379:methods*; D004569:Electroencephalography; D004574:Electromagnetic Fields; D004827:Epilepsy / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D007839:Functional Laterality / Q000502:physiology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008280:Magnetics / Q000627:therapeutic use*; D009044:Motor Cortex / Q000002:abnormalities* / Q000473:pathology / Q000503:physiopathology; D018482:Muscle, Skeletal / Q000294:innervation / Q000503:physiopathology; D009207:Myoclonus / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D016896:Treatment Outcome