Treating Non-epileptic Seizures Using Magnetic Brain Stimulation

Study Overview
=================
Brief Summary
-----------------
The purpose of this study is to investigate the feasibility of using repetitive transcranial magnetic stimulation (rTMS) - a form of non-invasive brain stimulation - to decrease the frequency of psychogenic non-epileptic seizure (PNES) episodes in patients with PNES.

Detailed Description
-----------------
This study is an open label pilot study that aims to recruit 15 individuals with diagnosed PNES to investigate the feasibility of using repetitive transcranial magnetic stimulation (rTMS) to decreasing the frequency of psychogenic non-epileptic seizure (PNES) episodes. rTMS is a non-invasive method of brain stimulation that uses rapid magnetic pulses applied over the scalp to active neurons in a specified target location of the brain. Electronic as well as paper-and-pencil questionnaires will be used to asses patient's psychiatric symptoms and functional impairment both before and after treatment to monitor symptom-changes.Treatment will consist of daily sessions of high frequency (20 Hz) rTMS applied over the right temporoparietal junction (TPJ) of the cerebral cortex. Patients will receive two sessions per day for 15 consecutive weekdays. Each session will take approximately 20 minutes to complete. Results of the questionnaires will be analyzed to determine the effect of the treatment on PNES episodes and functional impairment. As a pilot study, this research will be used to evaluate the effect size and the feasibility of a more definitive project in the future. Both patient response and tolerability to rTMS will be analyzed.

Official Title
-----------------
The Efficacy of Transcranial Magnetic Stimulation in the Treatment of Non-epileptic Seizures

Conditions
-----------------
Nonepileptic Seizures

Intervention / Treatment
-----------------
* Device: MagStim Rapid2 Transcranial Magnetic Simulation


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Confirmed Psychogenic Non-Epileptic Seizures Exclusion Criteria: Evidence of previous or comorbid epileptic seizures Major comorbid neurological diseases Currently taking medications that are known to reduce seizure-threshold Currently pregnant

Ages Eligible for Study
-----------------
Minimum Age: 18 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Patients<br>30 sessions of high-frequency (20Hz) repetitive stimulation applied over the right temporal-parietal junction in patients with psychogenic non-epileptic seizures using a MagStim Rapid2 Transcranial Magnetic Simulation machine. | Device: MagStim Rapid2 Transcranial Magnetic Simulation<br>* A non-invasive method of brain stimulation<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of Weekly Psychogenic Non-epileptic Seizure-events | Number of weekly seizure-events recorded using seizure logs. | One week and three months post-rTMS treatment | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
Psychogenic Non-Epileptic Seizure, Transcranial Magnetic Stimulation, Brain Stimulation