Randomized crossover sham-controlled clinical trial of targeted low-frequency transcranial magnetic stimulation comparing a figure-8 and a round coil to treat refractory neocortical XXXX .

@entity1 @entity410 @entity1625 @entity302
OBJECTIVE: Determine the efficacy and side effects of low-frequency repetitive transcranial magnetic stimulation (rTMS) to treat refractory neocortical @entity302 and study differences in effect between a figure-8 and round coil type. METHODS: This single-center randomized sham-controlled crossover trial (NCT01745952 on ClinicalTrials.gov) included 11 @entity1 with well-defined @entity1625 . rTMS (0.5 Hz) was targeted to the focus during three treatment conditions consisting of 1,500  stimulations/day for 10  weekdays at 90% of resting motor threshold (rMT) followed by a 10-week observation period. @entity1 were randomized for the order in which the figure-8, round, and sham coil were used. Outcome assessors and @entity1 were blinded to the type of coil used. The primary outcome measure was the percentage of @entity410 reduction after active rTMS treatment. Other outcome measures were responder rate, quality of life, and side effects. RESULTS: There was no difference between a figure-8 and round coil. None of the @entity1 achieved an overall 50% @entity410 reduction. One @entity1 responded during 1  month after treatment with either active coil, followed by a significant increase in @entity410 frequency. Another @entity1 had a fourfold increase in @entity410 frequency during rTMS treatment. SIGNIFICANCE: This study provides evidence that rTMS is on average not effective for reducing @entity410 frequency. No difference in effectiveness between the different coil types was observed. It can, however, exacerbate @entity410 during treatment and lead to a rebound in @entity410 frequency after an initial reduction.
