{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T18:06:11Z","timestamp":1792001171612,"version":"4.4.0"},"reference-count":50,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,11,8]],"date-time":"2024-11-08T00:00:00Z","timestamp":1731024000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81974204"],"award-info":[{"award-number":["81974204"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epilepsia"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Epilepsy is one of the most prevalent brain diseases. Approximately one third of patients consistently experience drug\u2010resistant epilepsy (DRE), a condition where seizures persist despite the use of antiseizure medications. Exploration of new therapies for DRE is urgently needed. In this single\u2010center, randomized, sham\u2010controlled, crossover clinical trial (NCT05042726), we aimed to investigate the effectiveness and safety of transcranial magnetic continuous theta burst stimulation (cTBS) targeting the cerebellum to treat DRE.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients with DRE for \u22652\u2009years and a seizure frequency of \u22652 seizures per month were enrolled and randomized 1:1 to receive active stimulation followed by sham stimulation or vice versa. The bilateral cerebellum was targeted by navigated cTBS focusing on the cerebellar dentate nucleus, once daily on workdays for 2\u2009weeks. The primary outcomes were the percentage of seizure reduction and 50% responder rate in the per\u2010protocol population within 2\u2009months after treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Forty\u2010four patients were enrolled and randomized; 18 patients in the active stimulation\u2010first group and 20 in the sham stimulation\u2010first group were included in the final analysis. Active cTBS significantly reduced seizures compared to sham stimulation (difference in percentage of seizure reduction between treatments\u2009=\u200925%, 95% confidence interval [CI] =\u20095%\u201346%, <jats:italic>p<\/jats:italic>\u2009=\u2009.018). The 50% responder rate after active stimulation was significantly higher than that after sham stimulation (difference in 50% responder rate between treatments\u2009=\u200924%, 95% CI\u2009=\u200911%\u201340%, <jats:italic>p<\/jats:italic>\u2009=\u2009.029). Adverse events occasionally occurred during active stimulation (moderate headache in 5% of patients, tinnitus in 3% of patients, dizziness in 3% of patients) but resolved spontaneously within days after treatment completion.<\/jats:p><\/jats:sec><jats:sec><jats:title>Significance<\/jats:title><jats:p>This trial suggested that cTBS targeting the cerebellum was effective and well tolerated in the treatment of DRE. Further studies are warranted to confirm its effectiveness and mechanism.<\/jats:p><\/jats:sec>","DOI":"10.1111\/epi.18168","type":"journal-article","created":{"date-parts":[[2024,11,8]],"date-time":"2024-11-08T15:09:47Z","timestamp":1731078587000},"page":"240-252","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Cerebellar transcranial magnetic stimulation to treat drug\u2010resistant epilepsy: A randomized, controlled, crossover clinical trial"],"prefix":"10.1111","volume":"66","author":[{"given":"Yuan\u2010Yuan","family":"Wang","sequence":"first","affiliation":[{"name":"Comprehensive Epilepsy Center, Department of Neurology, Xijing Hospital Fourth Military Medical University  Xi'an China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lei","family":"Ma","sequence":"additional","affiliation":[{"name":"Comprehensive Epilepsy Center, Department of Neurology, Xijing Hospital Fourth Military Medical University  Xi'an China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao\u2010Jing","family":"Shi","sequence":"additional","affiliation":[{"name":"Comprehensive Epilepsy Center, Department of Neurology, Xijing Hospital Fourth Military Medical University  Xi'an China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Liu","sequence":"additional","affiliation":[{"name":"Comprehensive Epilepsy Center, Department of Neurology, Xijing Hospital Fourth Military Medical University  Xi'an China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dian\u2010Wei","family":"Wu","sequence":"additional","affiliation":[{"name":"Comprehensive Epilepsy Center, Department of Neurology, Xijing Hospital Fourth Military Medical University  Xi'an China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian\u2010Min","family":"Hao","sequence":"additional","affiliation":[{"name":"Comprehensive Epilepsy Center, Department of Neurology, Xijing Hospital Fourth Military Medical University  Xi'an China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7004-8171","authenticated-orcid":false,"given":"Xiu\u2010Xiu","family":"Leng","sequence":"additional","affiliation":[{"name":"Comprehensive Epilepsy Center, Department of Neurology, Xijing Hospital Fourth Military Medical University  Xi'an China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lang","family":"Jin","sequence":"additional","affiliation":[{"name":"Comprehensive Epilepsy Center, Department of Neurology, Xijing Hospital Fourth Military Medical University  Xi'an China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4050-7362","authenticated-orcid":false,"given":"Fang","family":"Yuan","sequence":"additional","affiliation":[{"name":"Department of Neurology Second Affiliated Hospital of Guangzhou University of Chinese Medicine  Guangzhou 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