Repetitive Transcranial Magnetic Stimulation in the Treatment of Refractory Epilepsy：Research Progress and Technology Optimization

doi:10.12114/j.issn.1007-9572.2018.00.285

Abstract

Abstract: Epilepsy is a group of chronic neurological disorders caused by excessive neuronal activity in the cortex of the brain.Repetitive transcranial magnetic stimulation （rTMS） is a non-invasive neuroelectrophysiological technology which can modulate cortical excitability.Researches have showed that rTMS delivered into epileptogenic foci had an antiepileptic effect on patients with refractory epilepsy or status epilepticus and appears to be safe.Thus，rTMS may become one of the most promising neuro-stimulation modalities for refractory epilepsy.Further multi-center，large-sample randomized controlled trials are warranted to provide basis for evidence-based medicine.Meanwhile，rTMS for treatment of epilepsy still faces some challenges，especially on how to map targets accurately and how to prolong the treating effect.Based on present key problems，future researches should focus on developing high-resolution positioning technology，optimizing equipment and stimulus mode and exploring brain network connections and relevant TMS mechanism.

Key words: Epilepsy, Transcranial magnetic stimulation, Therapy, Status epilepticus, Stereotaxic techniques, Nerve net, Review

摘要： 癫痫是大脑皮质过度兴奋导致的慢性疾病。重复经颅磁刺激（rTMS）是一种非侵入性的调控大脑皮质兴奋性的神经电生理技术。目前研究表明，rTMS作用于致痫灶区能够减少癫痫发作、缓解癫痫持续状态，而且安全性较高，是较有前途的神经调控治疗癫痫的方法之一。未来多中心、大样本、随机对照研究可为其提供循证医学证据。同时，rTMS治疗癫痫时面临许多难题和挑战，特别是如何精确定位刺激靶点以及如何提高疗效的持久性。基于目前的难点，发展高分辨率的定位技术、优化刺激设备和刺激模式、探索脑网络连接和经颅磁刺激（TMS）作用机制将成为rTMS治疗癫痫未来的研究方向。

关键词: 癫痫, 经颅磁刺激, 治疗, 癫痫持续状态, 立体定位技术, 神经网, 综述

PENG Yan,LI Yingxuan,LIN Hua. Repetitive Transcranial Magnetic Stimulation in the Treatment of Refractory Epilepsy：Research Progress and Technology Optimization　[J]. Chinese General Practice, 2019, 22(26): 3250-3254. DOI: 10.12114/j.issn.1007-9572.2018.00.285.
彭艳,李莹萱,林华. 重复经颅磁刺激治疗难治性癫痫的研究进展及技术优化[J]. 中国全科医学, 2019, 22(26): 3250-3254. DOI: 10.12114/j.issn.1007-9572.2018.00.285.

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