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ORIGINAL RESEARCH article

Front. Neurosci.
Sec. Translational Neuroscience
Volume 18 - 2024 | doi: 10.3389/fnins.2024.1421917
This article is part of the Research Topic Exploiting Biomarkers of CNS Disorders: Targets for Therapeutics and Non-Invasive Tools for Diagnosis, Prognosis, Monitoring View all 10 articles

Increased cerebellar vermis volume following repetitive transcranial magnetic stimulation in drug-resistant epilepsy: a voxel-based morphometry study

Provisionally accepted
Mingyeong So Mingyeong So 1*Jooheon Kong Jooheon Kong 1*Young-Tak Kim Young-Tak Kim 2Keun-Tae Kim Keun-Tae Kim 3Hayom Kim Hayom Kim 1*Jung Bin Kim Jung Bin Kim 1*
  • 1 Department of Neurology, Korea University Anam Hospital, Seoul, Republic of Korea
  • 2 Department of Biomedical Sciences, Korea University College of Medicine, Seoul, Republic of Korea
  • 3 Department of Convergence Medicine, Korea University College of Medicine, Seoul, Republic of Korea

The final, formatted version of the article will be published soon.

    Voxel-based morphometry (VBM) was applied to explore structural changes induced by repetitive transcranial magnetic stimulation (rTMS) and the relationship with clinical outcomes.Moreover, the relationship between each segmented regional gray matter (GM) volume was investigated to identify circuits involved in the rTMS treatment process in patients with drugresistant epilepsy (DRE).Methods: Nineteen patients with DRE were finally included in the analysis. A session of rTMS was applied for 5 consecutive days. Participants received either 1,000 or 3,000 pulses, at a frequency of 0.5 Hz and the intensity was set at 90% of the individual's resting motor threshold. VBM analysis was performed to explore regional GM volume changes 2 months after rTMS application. The regional volume change was correlated with seizure reduction rate. Relationships between changes in GM volume in each anatomically parcellated region were analyzed using a fully-automated segmentation pipeline.Results: Compared to the baseline, seizure frequency was reduced, and quality of life was improved after rTMS treatment. Regional volume was increased in the cerebellar vermis 2 months after rTMS application. The increased cerebellar vermis volume correlated with the reduced seizure frequency.Regional volume changes in the cerebellar vermis were correlated with changes in the subcortical and cortical GM regions including the thalamus, caudate, and frontal cortex.Discussion: These results indicate that rTMS treatment effectively reduced seizure frequency in patients with DRE. Increased volume in the cerebellar vermis and activations of the cerebellothalamo-cortical circuit may be a crucial mechanism underlying the effectiveness of rTMS application in patients with DRE.

    Keywords: repetitive transcranial magnetic stimulation, voxel-based morphometry, Cerebellum, Vermis, Drug-resistant epilepsy

    Received: 23 Apr 2024; Accepted: 07 Oct 2024.

    Copyright: © 2024 So, Kong, Kim, Kim, Kim and Kim. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Mingyeong So, Department of Neurology, Korea University Anam Hospital, Seoul, Republic of Korea
    Jooheon Kong, Department of Neurology, Korea University Anam Hospital, Seoul, Republic of Korea
    Hayom Kim, Department of Neurology, Korea University Anam Hospital, Seoul, Republic of Korea
    Jung Bin Kim, Department of Neurology, Korea University Anam Hospital, Seoul, Republic of Korea

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