I have recently read an article about a study performed by Dr. Pavon and colleagues who investigated the emerging use of neuromodulation in the form of noninvasive electromagnetic brain stimulation (Dr. Pavon et al, 2019). Dr. Pavon and colleagues looked at a technique known as Transcranial Magnetic Stimulation (TMS) and its usage in stroke rehabilitation by delivering a time-varying pulse that is delivered to the brain (Dr. Pavon et al, 2019). This pulse is delivered by a coil that induces an electric field in the cortex and this produces neuronal activation when pyramidal cells and inhibitory interneurons are depolarized; Repetitive Transcranial Magnetic Stimulation (rTMS) occurs when a train of pulses is delivered to the brain and produces persistent effects (Dr. Pavon et al, 2019). Within the article, Dr. Pavon and colleagues explain that the rTMS is used after a stroke based on the inhibition model whereby excitability in the affected hemisphere is reduced and excitability in the unaffected hemisphere is increased (Dr. Pavon et al, 2019). The results found that after the rTMS had been delivered to the affected hemisphere it increase cortical excitability and therefore improve motor functions following a stroke (Dr. Pavon et al, 2019). After reading this article I began to wonder if it would be possible to use rTMS as an implantation device or other to help regulate neuronal activation in individuals with epilepsy. A study performed by Dr. Shon, Dr. Lim, and Dr. Lim investigated the effects of low-frequency rTMS on non-lesional focal refractory epilepsy, meaning that for many of these patients medicine does not help to bring their seizures under control (Dr. Shon et al, 2019). The investigation consisted of four patients that received a daily dose of 900 pulses of .5 Hz stimulation for 10 days over the epileptic foci (Dr. Shon et al, 2019). Dr. Shon and colleagues measured seizure reduction which had been measured at baseline (4 weeks), intervention (2 weeks), and follow-up (8 weeks). The results showed that patients 2,3, and 4 showed reductions in seizures, however; patient 1 did not show any reduction in seizures (Dr. Shon et al, 2019). The use of rTMS for patients that suffer from refractory epilepsy reduced the weekly rate of seizures by 75% and this persisted after the 8-week follow-up (Dr. Shon et al, 2019). Both Dr. Pavon’s and Dr. Shon's articles indicate that future researchers could possibly use rTMS or TMS to help stroke patients as well as patients with epilepsy. I think further research and exploration on the use of TMS and rTMS would be beneficial for many people in the future and should be further pursued in hopes of helping to alleviate some of the obstacles that patients with epilepsy face.
Works
Cited
Dr. Pavon et al, “Noninvasive
Transcranial Magnetic Brain Stimulation in Stroke.” Phys Med, vol. 30,
2019, pp.
319-335. https://doi.org/10.1016/j.pmr.2018.12.010
Dr. Shon et al, “Therapeutic
effect of repetitive transcranial magnetic stimulation on non-lesional focal
refractory epilepsy.”
Clinical Neuroscience, vol. 63, 2019, pp. 130-133.
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