title: Slow repetitive TMS for drug-resistant epilepsy: clinical and EEG findings of a placebo-controlled trial.
abstract: OBJECTIVE
  To assess the effectiveness of slow repetitive transcranial magnetic stimulation (rTMS) as an adjunctive treatment for drug-resistant epilepsy.
  
  
  METHODS
  Forty-three patients with drug-resistant epilepsy from eight Italian Centers underwent a randomized, double-blind, sham-controlled, crossover study on the clinical and EEG effects of slow rTMS. The stimulus frequency was 0.3 Hz. One thousand stimuli per day were given at the resting motor threshold intensity for 5 consecutive days, with a round coil at the vertex.
  
  
  RESULTS
  "Active" rTMS was no better than placebo for seizure reduction. However, it decreased interictal EEG epileptiform abnormalities significantly (p < 0.05) in one-third of the patients, which supports a detectable biologic effect. No correlation linked the rTMS effects on seizure frequency to syndrome or anatomic classification, seizure type, EEG changes, or resting motor threshold (an index of motor cortex excitability).
  
  
  CONCLUSIONS
  Although the antiepileptic action was not significant (p > 0.05), the individual EEG reactivity to "active" rTMS may be encouraging for the development of more-powerful, noninvasive neuromodulatory strategies.
authors.affiliation: Department of Clinical and Experimental Medicine, Section of Neurology, Amedeo Avogadro University, Novara, Italy. cantello@med.unipmn.it
authors.forename: Roberto
authors.initials: R
authors.lastname: Cantello
authors.forename: Simone
authors.initials: S
authors.lastname: Rossi
authors.forename: Claudia
authors.initials: C
authors.lastname: Varrasi
authors.forename: Monica
authors.initials: M
authors.lastname: Ulivelli
authors.forename: Carlo
authors.initials: C
authors.lastname: Civardi
authors.forename: Sabina
authors.initials: S
authors.lastname: Bartalini
authors.forename: Giampaolo
authors.initials: G
authors.lastname: Vatti
authors.forename: Massimo
authors.initials: M
authors.lastname: Cincotta
authors.forename: Alessandra
authors.initials: A
authors.lastname: Borgheresi
authors.forename: Gaetano
authors.initials: G
authors.lastname: Zaccara
authors.forename: Angelo
authors.initials: A
authors.lastname: Quartarone
authors.forename: Domenica
authors.initials: D
authors.lastname: Crupi
authors.forename: Angela
authors.initials: A
authors.lastname: Laganà
authors.forename: Maurizio
authors.initials: M
authors.lastname: Inghilleri
authors.forename: Anna Teresa
authors.initials: AT
authors.lastname: Giallonardo
authors.forename: Alfredo
authors.initials: A
authors.lastname: Berardelli
authors.forename: Loredana
authors.initials: L
authors.lastname: Pacifici
authors.forename: Florinda
authors.initials: F
authors.lastname: Ferreri
authors.forename: Mario
authors.initials: M
authors.lastname: Tombini
authors.forename: Francesca
authors.initials: F
authors.lastname: Gilio
authors.forename: Pierpaolo
authors.initials: P
authors.lastname: Quarato
authors.forename: Antonella
authors.initials: A
authors.lastname: Conte
authors.forename: Paolo
authors.initials: P
authors.lastname: Manganotti
authors.forename: Liugi Giuseppe
authors.initials: LG
authors.lastname: Bongiovanni
authors.forename: Francesco
authors.initials: F
authors.lastname: Monaco
authors.forename: Daniela
authors.initials: D
authors.lastname: Ferrante
authors.forename: Paolo Maria
authors.initials: PM
authors.lastname: Rossini
mesh_terms: D000328:Adult; D015331:Cohort Studies; D018592:Cross-Over Studies; D004311:Double-Blind Method; D004351:Drug Resistance; D004569:Electroencephalography / Q000706:statistics & numerical data*; D004827:Epilepsy / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D004833:Epilepsy, Temporal Lobe / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D019579:Neocortex / Q000503:physiopathology; D010919:Placebos; D018401:Sample Size; D050781:Transcranial Magnetic Stimulation / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D010919:Placebos