TMS-EMG and TMS-EEG as a biomarker for pharmacological effects on cortical excitability

A novel biomarker with great potential

CHDR is actively engaged in developing new biomarkers and optimising existing biomarkers to study compounds that penetrate the central nervous system (CNS). We have recently evaluated transcranial magnetic stimulation (TMS) coupled with electromyography (EMG) and electroencephalography (EEG) as a biomarker to study the clinical effects of drugs that are expected to affect cortical excitability. Both single-pulse and paired-pulse TMS stimulation protocols have been implemented at CHDR and can be customised according to study design.

Clinical evaluation

Together with the Clinical Neurophysiology (CNPH) Group of the University of Twente - one of our closest collaborators in the field of cortical excitability testing - we have evaluated the effects of levetiracetam, valproic acid and lorazepam on cortical excitability in healthy volunteers. Our findings indicate that levetiracetam, valproic acid and lorazepam show significant effects on cortical excitability as measured by single-pulse and paired-pulse TMS-EMG and TMS-EEG.

View study details here

Future directions

We welcome our clients to explore the possibilities of using TMS-EMG and TMS-EEG to study the clinical effects of CNS-active drugs that modulate cortical excitability. By supporting TMS-EMG and TMS-EEG in both sponsored and investigator-initiated clinical drug trials, we aim to actively expand knowledge in this area. We also strive for continuous improvements to our TMS methodology, by adding neuronavigation tools, optimising stimulation protocols and developing new methods of statistical analysis.

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