Article

In recent years, a number of novel brain-stimulation techniques
have been developed (such as TMS-EEG, TMS-fMRI and TMS-NIRS), yet they remain
underutilized in the field of epilepsy. Accumulating evidence suggests that
transcranial magnetic stimulation (TMS) combined with electroencephalography
(TMS-EEG) is a highly relevant technique for exploration of the pathophysiology
of human epilepsies as well as a promising biomarker with diagnostic and
prognostic potential. RESULTS: In genetic generalized epilepsies, TMS-EEG has
provided pathophysiological insight by revealing quasi-stable, covert states of
excitability, a subclass of which is associated with the generation of
TMS-induced epileptiform discharges (EDs). In focal epilepsy, TMS-induced EDs
were successfully employed to identify the epileptogenic zone. In addition, TMS
trains applied during focal EDs can terminate them, and appear to restore the
effective connectivity of the brain network significantly altered by EDs. This
abortive effect of TMS on EDs may possibly serve as a biomarker of response to
invasive neuromodulatory techniques. CONCLUSION: TMS-EEG-based stimulation
paradigms can provide insight into the mechanisms underlying human epilepsies
and, thus, warrant further study as diagnostic and prognostic biomarkers.
CI - Copyright (c) 2016 Elsevier Masson SAS. All rights reserved.

Langue : ANGLAIS