Effects of continuous theta burst transcranial magnetic stimulation on cortical excitability in patients with idiopathic generalized epilepsy
Abstract Introduction Transcranial magnetic stimulation (TMS) is a noninvasive technique for investigating cortical physiologic functions in the brain. In this study, the effects of continuous theta burst stimulation (cTBS) on motor evoked potential (MEP) parameters in patients with idiopathic generalized epilepsy (IGE) were investigated. Materials and methods Fifteen patients with IGE were included. Motor threshold (MT) and cortical silent period (CSP) were determined before cTBS application. Next, cTBS was applied to the dominant (left) hemisphere M1 hand area as the first application. After 1 day, cTBS was applied first to the left M1 hand area and then to the right lateral cerebellar area as the second application. Parameters were again determined after the applications. Results There was no difference in resting MT values before and after cTBS application (p>0.05). Although CSP increased after stimulation (p 0.05). Conclusion For patients with epilepsy, cTBS is a safe technique when applied at a low intensity. The inhibitory effect of cTBS, a noninvasive technique, on cortical excitability in patients with IGE was determined using MEP parameters. The effect lasted at least 1 h. To our knowledge, this is the first study to assess the effect of cTBS on cortical excitability in patients with IGE. Our findings indicate that cTBS decreases cortical excitability in patients with IGE. Highlights Delirium is a common complication in elderly patients after surgery. Preoperative severe hypoalbuminemia (defined as serum albumin ≤30.0g/L) is independently associated with an increased risk of developing postoperative delirium; it is also associated with other worse outcomes after surgery. Whether prophylactic correction of preoperative severe hypoalbuminemia can improve postoperative outcomes of elderly patients is still unknown.
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