rTMS and Lorazepam

Listen as Basic Science Editor Sloka Iyengar PhD talks about a study published in Epilepsy & Behavior about repetitive transcranial magnetic stimulation (rTMS) and lorazepam in the treatment for status epilepticus.

Gersner R, Dhamne SC, Zangen A, Pascual-Leone A, Rotenberg A. In Epilepsy & Behavior 2016; 62:136-139.

Purpose

  • Status epilepticus (SE) is a condition of prolonged seizures and can be convulsive or non-convulsive.
  • Unfortunately, the diagnosis and treatment for SE are not straight-forward.
  • Benzodiazepines such as lorazepam are used for SE, but these drugs are associated with excessive sleepiness.
  • Repetitive transcranial magnetic stimulation (rTMS) is a method where a magnet placed on the scalp produces a magnetic field. Use of rTMS has been shown to reduce activity in that particular part of the brain.
  • In the paper published in Epilepsy & Behavior, the authors wanted to find out if the combination of rTMS and lorazepam was able to stop seizures in SE.

Description of study

  • This study was done in experimental rats in the lab.
  • A model of SE called the kainite model was used.
    • Rats were given a drug called kainic acid and were monitored by electroencephalogram (EEG).
    • Epileptic spikes were counted before, during, and after treatment.
  • Two experiments were done:
    • rTMS alone
    • rTMS along with lorazepam
  • The dose of lorazepam used was not capable of stopping seizures on its own, but was less likely to cause side-effects of sedation.

Summary of study findings

  • The authors found that rTMS alone decreased epileptic spikes, but only for a short period of time.
  • However, a combination of rTMS with low-dose lorazepam was more effective.

Future experimentation

We still do not know the mechanism behind this effect of rTMS, and future experiments will be necessary to explore this further. If these results hold true in future studies, rTMS can be used with lorazepam, decreasing the side-effects usually seen with lorazepam.

Article published in Epilepsy & Behavior, September 2016.

Authored by: Sloka Iyengar PhD | Basic Science Editor on 6/2017