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

This double-blind, placebo-controlled crossover study evaluated transcranial magnetic stimulation (TMS) combined with electromyography and electroencephalography as biomarkers for assessing anti-seizure medication effects in 26 patients with generalized epilepsy. Levetiracetam significantly reduced cortical excitability markers (reduced motor-evoked potentials, enhanced intracortical inhibition, increased gamma/beta power), suggesting TMS-derived measures are valid translational biomarkers for early-phase drug development and treatment-resistant epilepsy.