The paradoxical effect of levetiracetam (LEV) refers to the paradoxical aggravation of epileptic seizures during clinical application. In this case, we report for the first time a patient with MRI-negative drug-resistant frontal lobe epilepsy who developed nonconvulsive status epilepticus (NCSE) following LEV dose escalation, as documented by stereoelectroencephalography (SEEG). The SEEG findings suggested that paradoxical activation of mesial temporal structures may be involved in the occurrence of LEV-induced paradoxical effects.
Objective This study investigated the effects of transcranial photobiomodulation (tPBM) targeting the supplementary motor area (SMA) on motor performance and neural activity in healthy individuals. Methods In a randomized, double-blind, sham-controlled trial, 60 right-handed participants received active tPBM (850 nm, 60 mW/cm 2 , 36 J/cm 2 ) or sham stimulation over the SMA for four consecutive days. Motor performance was assessed using a sequential finger-tapping task for both hands. Neural activity was evaluated using quantitative electroencephalography (qEEG) at rest. Results Active tPBM significantly improved non-dominant hand motor performance compared to sham, with reductions in reaction time and total movement time, and increased accuracy (all p < 0.001 after Bonferroni correction). qEEG showed significant increases in alpha and beta power at C3 and C4 electrodes in the active group (all p < 0.001 after correction). No significant changes were observed in the sham group. Conclusion These findings suggest that short-term tPBM targeting the SMA can enhance motor performance, particularly of the non-dominant hand, and increase sensorimotor alpha and beta power in healthy young adults. Further research is needed to clarify the underlying mechanisms and potential clinical applications.
Autism spectrum disorder (ASD) is a neurobiologically heterogeneous neurodevelopmental condition, yet current treatment approaches — predominantly behavioral and communicative — pharmacological option limited to symptomatic relief, with limited benefit for individuals with more severe presentations. Here we report an 8-year-old male with ASD presenting with social withdrawal, anxiety, and self-injurious behavior (SIB), who underwent quantitative electroencephalography(qEEG)-guided deep transcranial magnetic stimulation (dTMS) over 40 sessions. Baseline qEEG demonstrated generalized cortical hyperexcitability — characterized by elevated absolute power across most frequency bands and diffuse coherence elevation — consistent with a maturational lag pattern previously described in ASD. We hypothesized that this profile might offer a neurobiological rationale for BDNF-activating neuromodulatory approach via dTMS. Serial qEEG assessments every 10 sessions enabled quantitative monitoring of treatment response; introduction of the H7 coil from the 21st session associated with subsequent delta reduction and partial resolution of central/posterior high-beta activity. CARS-2 scores decreased from 34 at baseline to 20 at treatment completion — a 41% reduction, representing a shift to the non-autistic range — coinciding with reduced anxiety-related behaviors, improved language, and overall reduction in SIB. This case illustrates the potential dual utility of qEEG as a neurophysiological profiling tool and a quantitative biomarker of treatment response, contributing preliminary evidence for the clinical utility of dTMS in ASD and highlighting the value of neurophysiologically informed, precision-based approach to psychiatric care.
ObjectiveTo evaluate the efficacy and safety of high-frequency deep repetitive transcranial magnetic stimulation (HF-dTMS) for depressive disorder and to explore whether baseline fasting triglyceride (TG) levels predict treatment response.MethodsIn this randomized, sham-controlled trial, 80 patients with moderate-to-severe depressive disorder were allocated to active HF-dTMS (n = 40) or sham stimulation (n = 40). Participants received 20 sessions over 4 weeks. The primary outcome was the change in Hamilton Depression Rating Scale (HAMD-17) scores from baseline to the end of treatment. Fasting TG levels were measured at baseline. We examined the association between baseline TG and symptom improvement and tested the interaction between TG and treatment assignment.ResultsActive HF-dTMS produced a significantly greater reduction in HAMD-17 scores than sham stimulation. Higher baseline TG levels were associated with greater symptom improvement. The relationship between TG and treatment response was stronger in the active HF-dTMS group than in the sham group, indicating that baseline TG may modify the treatment effect.ConclusionHF-dTMS was generally well tolerated and was associated with greater reductions in depressive symptoms than sham stimulation. Baseline fasting TG levels may be associated with the magnitude of treatment response and could serve as a potential exploratory biomarker for individualized dTMS treatment strategies.
Schizophrenia (Sz) involves positive symptoms such as auditory hallucinations, paranoia, and delusions, and are commonly linked to deficits in cognitive control. These deficits appear in tasks like the A-X version of the continuous performance test (AX-CPT), which reflects reduced proactive control, and in diminished auditory steady-state responses (ASSR) during selective attention. Notably, in Sz, ASSR to sounds presented during diverted attention increases with hallucination severity. We report results from a single-blind randomized controlled trial evaluating Auditory Control Enhancement (ACE) therapy-the combination of transcranial direct current stimulation (tDCS) paired with Auditory Cognitive Control Training (ACCT)-to improve cognitive control in Sz. Ten individuals with Sz participated: six received active ACE and four received sham tDCS with ACCT. All experienced auditory hallucinations at least three days per week. ACCT consisted of three 45-min computerized sensory reaction-time sessions over three consecutive days. All procedures, including baseline and follow-up assessments, were performed over a two-week period. Electroencephalography (EEG) was collected before and after training while participants completed AX-CPT and ASSR tasks. ASSR blocks alternated between attending to auditory stimuli and ignoring them while watching a silent video. Auditory hallucinations were assessed using the PSYRATS at baseline and post-intervention. Procedures were well tolerated, and acceptability was high. Participants receiving ACE showed increased attention modulation (larger ASSR attend-ignore difference), greater beta desynchronization during proactive inhibition, and reductions in physical aspects of auditory hallucinations. In contrast, the sham group showed no changes in EEG measures or hallucination severity. These preliminary results suggest ACE may enhance cognitive control and reduce physical aspects of auditory hallucinations in Sz. ACE could represent a promising intervention for cognitive dysfunction.
