Repetitive Transcranial Magnetic Stimulation Modulates Brain Connectivity in Children with Self-limited Epilepsy with Centrotemporal Spikes.

IF 7.6 1区医学 Q1 CLINICAL NEUROLOGY Brain Stimulation Pub Date : 2025-02-24 DOI:10.1016/j.brs.2025.02.018

Xiwei She, Wendy Qi, Kerry C Nix, Miguel Menchaca, Christopher C Cline, Wei Wu, Zihuai He, Fiona M Baumer

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Abstract

Objective: Self-limited epilepsy with centrotemporal spikes (SeLECTS) is a common pediatric syndrome in which interictal epileptiform discharges (IEDs) emerge from the motor cortex and children often develop language deficits. IEDs may induce these language deficits by pathologically enhancing brain connectivity. Using a sham-controlled design, we test the impact of inhibitory low-frequency repetitive transcranial magnetic stimulation (rTMS) on connectivity and IEDs in SeLECTS.

Methods: Nineteen children participated in a cross-over study comparing active vs. sham motor cortex rTMS. Single pulses of TMS combined with EEG (spTMS-EEG) were applied to the motor cortex before and after rTMS to probe connectivity. Connectivity was quantified by calculating the weighted phase lag index (wPLI) between six regions of interest: bilateral motor cortices (implicated in SeLECTS) and bilateral inferior frontal and superior temporal regions (important for language). IED frequency before and after rTMS was also quantified.

Results: Active, but not sham, rTMS decreased wPLI connectivity between multiple regions, with the greatest reductions seen in superior temporal connections in the stimulated hemisphere. IED frequency decreased after active but not sham rTMS.

Significance: Low-frequency rTMS reduces pathologic hyperconnectivity and IEDs in children with SeLECTS, making it a promising avenue for therapeutic interventions for SeLECTS and potentially other pediatric epilepsy syndromes.

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目的：自限性癫痫伴心颞区棘波（SeLECTS）是一种常见的儿科综合征，发作间期痫样放电（IED）从运动皮层出现，儿童往往会出现语言障碍。IED可能通过病理性增强大脑连通性而诱发这些语言障碍。通过假对照设计，我们测试了抑制性低频重复经颅磁刺激（rTMS）对 SeLECTS 的连接性和 IED 的影响：19名儿童参加了一项交叉研究，比较主动与假性运动皮层经颅磁刺激。在经颅磁刺激前后，对运动皮层施加结合脑电图（spTMS-EEG）的单脉冲经颅磁刺激，以探测连接性。通过计算六个相关区域之间的加权相位滞后指数（wPLI）来量化连接性：双侧运动皮层（与 SeLECTS 有关）以及双侧额叶下部和颞叶上部区域（对语言很重要）。经颅磁刺激前后的 IED 频率也进行了量化：结果：经颅磁刺激有效而非无效降低了多个区域之间的 wPLI 连接，受刺激半球颞上部连接的降低幅度最大。主动经颅磁刺激后，IED频率降低，而非假经颅磁刺激：意义：低频经颅磁刺激可降低SeLECTS患儿的病理超连接性和IED，使其成为治疗干预SeLECTS和其他潜在小儿癫痫综合征的一个很有前景的途径。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Brain Stimulation 医学-临床神经学

CiteScore

13.10

自引率

9.10%

发文量

256

审稿时长

72 days

期刊介绍： Brain Stimulation publishes on the entire field of brain stimulation, including noninvasive and invasive techniques and technologies that alter brain function through the use of electrical, magnetic, radiowave, or focally targeted pharmacologic stimulation. Brain Stimulation aims to be the premier journal for publication of original research in the field of neuromodulation. The journal includes: a) Original articles; b) Short Communications; c) Invited and original reviews; d) Technology and methodological perspectives (reviews of new devices, description of new methods, etc.); and e) Letters to the Editor. Special issues of the journal will be considered based on scientific merit.