On March 31st, Dr. Hui Ye presented on neuromodulation with electromagnetic stimulation for seizure suppression. The article his speech stemmed from was, "Neuromodulation with electromagnetic stimulation for seizure suppression: From electrode to magnetic coil," in which different types of electromagnetic stimulation for seizures were evaluated. These stimulation mechanisms were evaluated across four measures: direct membrane polarization by the magnetic field, depolarization blockade by the deactivation of ion channels, alteration in synaptic transmission, and interruption of ephaptic interaction and cellular synchronization. While two types of electric stimulation have been proven effective for epilepsy – vagus nerve stimulation (VNS) and deep brain stimulation (DBS), according to Dr. Hui Ye, they have both technical and biological limitations.
In his research, Dr. Hui Ye looked at magnetic stimulation (TMS) as an alternative method for neural modulation. As compared to electric stimulation, magnetic stimulation offered advantages such as biocompatibility and consistency – most importantly, it may stimulate neuron tissue without surgery to place leads or coils. Unlike DBS or VNS. Along with that, Dr. Hui Ye highlights that magnetic stimulation can prevent direct contact between an electrode and neural tissue, possibly eliminating numerous problems that can arise from such direct contact.
With such promising new research stemming from magnetic stimulation, I wanted to understand more about its long-term effects and its prospects. Chen et al. looked at the evidence for the use of TMS in individuals with epilepsy compared to other available treatments. They compared across a couple measures: reduction in seizure frequency, improvement in the quality of life, reduction in epileptiform discharges, antiepileptic medication use, and side-effects.
What they found was that in some trials, out of seven, there was a reduced number of seizures as compared to before the therapy, but in other trials, there was not a significant difference in the seizure frequency. With a slight reduction in epileptiform discharges in four out of seven trials. As well, there was not an overall change in the quality of life, and only one report in an increase in antiepileptic medication.
Overall, the clinical role of TMS in epilepsy seems to be uncertain. Both Dr. Hui Ye and the other researchers understand that while it has some valuable components that are promising, there is limited data on the long-term outcomes of TMS. As, well Dr. Hui Ye and Chen et al. state that there needs to be more advancement in design and stimulation protocols in order to fully understand and obtain accurate results. Until more controlled trials are done pertaining to seizure treatment and magnetic stimulation, it seems as though procedures such as DBS and VNS will remain at the forefront of seizure treatment.
Chen R, Spencer DC, Weston J, Nolan SJ. Transcranial magnetic stimulation for the treatment of
epilepsy. Cochrane Database of Systematic Reviews 2016, Issue 8. Art. No.: CD011025.
DOI: 10.1002/14651858.CD011025.pub2
Ye, H., & Kaszuba, S. (2019). Neuromodulation with electromagnetic stimulation for seizure
suppression: From electrode to magnetic coil. IBRO Reports, 7, 26–33. doi:
10.1016/j.ibror.2019.06.001
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