Abstract:
Transcranial magnetic stimulation (TMS) with electroencephalography (EEG), that is TMS-EEG, may assist in managing epilepsy. We systematically reviewed the quality of reporting and findings in TMS-EEG studies on people with epilepsy and healthy controls, and on healthy individuals taking anti-seizure medication. We searched the Cochrane Library, Embase, PubMed and Web of Science databases for original TMS-EEG studies comparing people with epilepsy and healthy controls, and healthy subjects before and after taking anti-seizure medication. Studies should involve quantitative analyses of TMS-evoked EEG responses. We evaluated the reporting of study population characteristics and TMS-EEG protocols (TMS sessions and equipment, TMS trials and EEG protocol), assessed the variation between protocols, and recorded the main TMS-EEG findings. We identified 20 articles reporting 14 unique study populations and TMS methodologies. The median reporting rate for the group of people with epilepsy parameters was 3.5/7 studies and for the TMS parameters was 13/14 studies. TMS protocols varied between studies. Fifteen out of 28 anti-seizure medication trials in total were evaluated with time-domain analyses of single-pulse TMS-EEG data. Anti-seizure medication significantly increased N45, and decreased N100 and P180 component amplitudes but in marginal numbers (N45: 8/15, N100: 7/15, P180: 6/15). Eight articles compared people with epilepsy and controls using different analyses, thus limiting comparability. The reporting quality and methodological uniformity between studies evaluating TMS-EEG as an epilepsy biomarker is poor. The inconsistent findings question the validity of TMS-EEG as an epilepsy biomarker. To demonstrate TMS-EEG clinical applicability, methodology and reporting standards are required.
摘要:
经颅磁刺激(TMS)与脑电图(EEG),那就是TMS-EEG,可能有助于治疗癫痫。我们系统地回顾了癫痫患者和健康对照的TMS-EEG研究的报告和发现的质量,以及服用抗癫痫药物的健康个体。我们搜查了Cochrane图书馆,Embase,PubMed和WebofScience数据库,用于比较癫痫患者和健康对照者的原始TMS-EEG研究,和健康受试者服用抗癫痫药物前后。研究应涉及TMS诱发的EEG反应的定量分析。我们评估了研究人群特征和TMS-EEG协议的报告(TMS会议和设备,TMS试验和EEG协议),评估协议之间的差异,并记录TMS-EEG的主要发现。我们确定了20篇文章,报道了14个独特的研究群体和TMS方法。癫痫患者参数组的中位报告率为3.5/7研究,TMS参数为13/14研究。TMS协议在研究之间有所不同。通过对单脉冲TMS-EEG数据的时域分析,对28项抗癫痫药物试验中的15项进行了评估。抗癫痫药物显着增加N45,并降低N100和P180分量的振幅,但数量有限(N45:8/15,N100:7/15,P180:6/15)。八篇文章使用不同的分析比较了癫痫患者和对照组,从而限制了可比性。评估TMS-EEG作为癫痫生物标志物的研究之间的报告质量和方法学一致性较差。不一致的发现质疑TMS-EEG作为癫痫生物标志物的有效性。为了证明TMS-EEG临床适用性,方法和报告标准是必需的。