ArticleBMJ connections surgery2026
Repetitive transcranial magnetic stimulation (rTMS) for the treatment of epilepsy: a systematic review and meta-analysis of clinical trials (from 1990 to 2025).
Article in BMJ connections surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Objectives: This systematic review and meta-analysis evaluates the efficacy of repetitive transcranial magnetic stimulation (rTMS) in reducing seizure frequency in patients with epilepsy, synthesising evidence from randomised controlled trials (RCTs). Design: Systematic review and meta-analysis of RCTs conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020 guidelines. Setting: Literature search across international (PubMed, EMBASE, Cochrane, Scopus, ScienceDirect, Google Scholar) and Iranian (SID, Magiran, IranMedex) databases. Participants: Adult patients diagnosed with epilepsy, including those with drug-resistant focal epilepsy, from 14 included RCTs (total n=516). Interventions: Active low-frequency rTMS (0.3-1 Hz) compared with sham stimulation or active control (eg, antiepileptic drug therapy). Main outcome measures: The primary outcome was the mean change in weekly seizure frequency analysed using standardised mean difference (SMD). Results: From 1952 retrieved records, 14 RCTs were reviewed and 8 were meta-analysed (n=367). The pooled analysis showed a statistically significant reduction in seizure frequency favouring rTMS (SMD=-0.46, 95% CI -0.57 to -0.34, p=0.001, Z=-7.67), with low heterogeneity (I²=0.1%). The combined mean seizures were 6.1 (intervention) versus 7.4 (control) per week. No significant publication bias was detected (Egger's test p=0.086). Conclusions: Low-frequency rTMS demonstrates a significant short-term reduction in seizure frequency. However, the clinical durability of this effect remains uncertain due to limited follow-up in existing trials. Definitive conclusions require larger, standardised RCTs with longer-term outcomes. Trial registration: No human participants included.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.