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May 16, 2026Clinical Pharmacology & Therapeutics

Transcranial Magnetic Stimulation as a Translational Biomarker in Early‐Phase Anti‐Seizure Medication Development: A Randomized, Double‐Blind, Placebo‐Controlled Study in Generalized Epilepsy

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Authors

CCCatherine M. E. de CubaTRTitia Q. RuijsAGAnnika A. de Goede

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Overview

Randomized trial demonstrates TMS-derived biomarkers assessing ASM effects in generalized epilepsy, indicating potential for drug development.

Key Points

  • To establish transcranial magnetic stimulation (TMS)-derived endpoints as biomarkers for assessing anti-seizure medication effects in epilepsy patients.
  • Randomized, double-blind, placebo-controlled, two-way crossover design involving 26 patients with generalized epilepsy.
  • Patients received a single oral dose of levetiracetam (2000 mg) or placebo after refraining from their morning ASM dose.
  • Assessment included TMS, electromyography (EMG), electroencephalography (EEG), and resting-state EEG pre-dose and post-dose at defined intervals.
  • Levetiracetam significantly reduced motor-evoked potential (MEP) amplitude (p<0.05) and enhanced long-interval intracortical inhibition (LICI).
  • Increased frontal gamma and beta power noted, especially in levetiracetam-naïve patients (p<0.05).
  • TMS-EEG showed distinct early and late potential components between levetiracetam patients and naïve patients, indicating sensitivity to ASM effects.

Cite This Study

Cuba et al. (2026) studied this question.

synapsesocial.com/papers/6a080a71a487c87a6a40c5f2https://doi.org/10.1002/cpt.70327
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