Efficacy of Personnalized Transcranial Direct Current Electrical Stimulation (tDCS) in Drug-resistant Epileptic (GALVANI GS-3)
Model-based Multichannel Transcranial Direct Current Electrical Stimulation (tDCS) in Drug-resistant Epilepsy: A Cross-over Study of Efficacy
The goal of this clinical trial is to to obtain a significant decrease in seizure frequency in patients with refractory focal epilepsy after applying treatment of cathodal tDCS, compared to sham stimulation drug-resistant epileptic patient. The main questions it aims to answer are:
- Changes in quality of life
- Percent of newly reported side effects after the stimulation period
- Scores in epilepsy severity. Participants will be randomized in a cross-over, and will receive 10 days of tDCS or Sham. Each day will allow 2 periods of 20 minutes stimulation separated by 20 minutes off (with 40 minutes of cathodal stimulation total).
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Fabrice Bartolomei, MD, PhD
- Phone Number: 33 0491384990
- Email: fabrice.bartolomei@ap-hpm.fr
Study Contact Backup
- Name: Sophie Tardoski
- Phone Number: 33 0491381594
- Email: sophie.tardoski@ap-hm.fr
Study Locations
-
-
-
Bordeaux, France, 33000
- Recruiting
- Service de Neurophysiologie Clinique de l'Enfant et de L'Adulte, Pôle de Neurosciences Cliniques
-
Contact:
- Jerome Aupy
- Email: Jerome.aupy@chu-bordeaux.fr
-
Bron, France, 69677
- Recruiting
- Département Neurologie Fonctionnelle et Epilepsie, Hôpital neurologique - Hospices Civils de Lyon
-
Contact:
- Sylvain Rheims
- Email: Sylvain.rheims@chu-lyon.fr
-
Lille, France, 59037
- Not yet recruiting
- Service de Neurophysiologie clinique - Hôpital Roger Salengro, CHU Lille
-
Contact:
- Philippe Derambure
- Email: Philippe.Derambure@chru-lille.fr
-
Marseille, France, 13005
- Recruiting
- Service Epileptologie et Rythmologie Cérébrale, Hôpital La Timone
-
Contact:
- Fabrice Bartolomei
- Email: fabrice.bartolomei@ap-hm.fr
-
Paris, France, 75014
- Not yet recruiting
- Service de Neurophysiologie clinique - GHU Psychiatrie et Neurosciences Sainte-Anne
-
Contact:
- Martine Gavaret
- Email: m.gavaret@ghu-paris.fr
-
Rennes, France, 35033
- Not yet recruiting
- Service de Neurologie - CHU de Rennes - Hôpital Pontchaillou
-
Contact:
- Anca Nica
- Email: Anca.nica@chu-rennes.fr
-
Toulouse, France, 31059
- Not yet recruiting
- Explorations neurophysiologiques - Pôle neurosciences, CHU de Toulouse, Hôpital Pierre Paul Riquet
-
Contact:
- Luc Valton
- Email: valton.l@chu-toulouse.fr
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Child
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Patient, parents or legal representative who have given written informed consent;
- Age: ≥ 9 years;
- Patients with drug-resistant focal epilepsy with no evolutive brain lesion and no surgical indication or with a previous surgical failure, refusing surgery or with a planned surgery compatible with the total duration of this study;
- SEEG previously performed before inclusion with an adequate definition of the epileptogenic zone with all data required (pre-SEEG MRI, CT-scan or MRI with electrodes during SEEG and SEEG files) for personalization ;
- Patient having a pre-SEEG 3D-T1 MRI and CT-scan with electrodes during SEEG available; This MRI can be done specifically for this trial or might be reused from EPINOV or NEURO7T trial)
- For patients with VNS, experiencing no response or partial response, and for whom the stimulation parameters have been stable for at least 6 months
- A research MRI scan that is suitable for navigated brain stimulation (NBS) and generation of electrical fields including dMRI for tractography;
- Number of seizures ≥3/month during the baseline (before the first session of tDCS treatment);
- Patient having stable medications for epilepsy 4 weeks before the baseline (except rescue treatment);
- Patient's IQ, which in the investigator's opinion will enable questionnaires and neuropsychological assessments to be carried out;
- Patient able to understand, speak and write in French;
- Patient able to follow study's procedure;
- Patient beneficiary or affiliated to a health insurance plan.
Exclusion Criteria:
- Patients with seizures of generalized onset in the last 12 months;
- Patient with multifocal epileptogenic zones, bilateral epileptogenic zone, or poorly defined epileptogenic zone. The epileptogenic network should not be restricted to the orbito frontal cortex or cingulate cortex;
- Patients with psychogenic nonepileptic seizures;
- Patient presenting a contraindication to MRI 3T (patient having a pacemaker, metallic foreign bodies, non-removably implanted electronic medical devices, claustrophobia, inability to remain in supine position, vagus nerve stimulator even when switched off is a contraindication for MRI 3T. EPINOV or NEURO 7T trial patients, who have accepted for their data to be reused, can be included even while wearing a VNS device) ;
- Substance use abuse that may include alcohol , opioids (heroin, fentanyl) stimulants (Cocaine, methamphetamine) , hallucinogens (LSD, psilocybin (magic mushrooms), MDMA (Ecstasy))
- Patient presenting a serious intercurrent pathology and/or a progressive brain tumor
- Patient having damaged skin or scalp that may interfere with tDCS stimulation (e.g., eczema, lesion);
- Patient having any cranial metal implants such as shrapnel or surgical clips (excluding <1 mm thick epicranial titanium skull plates and dental fillings) or medical devices (i.e. cardiac pacemaker, deep brain stimulator, medication infusion pump, cochlear implant)
- Patient having previous surgeries opening the skull leaving skull defects capable of allowing the insertion of a cylinder with a radius greater or equal to 5 mm;
- Any condition that makes the study subject, in the opinion of the investigator, unsuitable for the study including presence of any disease, abnormality, medical or physical condition that, in the opinion of the investigator, may adversely impact, compromise, interfere, limit, affect or reduce the safety of the subject, the integrity of the data ;
- Person protected by articles L1121-5, L1121-6 of Public Health Code (pregnant or breastfeeding woman, deprived of liberty by judicial decision, situations of social fragility, adults unable or unable to express their consent, person under judicial safeguard (article L1122-2)).
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Crossover Assignment
- Masking: Triple
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Other: tDCS - Sham
Patient will be randomized to firstly receive tDCS (10 non consecutive days, 20 minutes twice a day with 20 minutes of break) and then Sham (10 non consecutive days, 20 minutes twice a day with 20 minutes of break).
|
Research MRI includes 3D-T1 weighted MRI (3D-T1), diffusion MRI (dMRI), resting-state functional MRI (rsfMRI).
Other Names:
|
|
Other: Sham - tDCS
Patient will be randomized to firstly receive Sham (10 non consecutive days, 20 minutes twice a day with 20 minutes of break) and then tDCS (10 non consecutive days, 20 minutes twice a day with 20 minutes of break).
|
Research MRI includes 3D-T1 weighted MRI (3D-T1), diffusion MRI (dMRI), resting-state functional MRI (rsfMRI).
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
To obtain a significant seizure frequency change at the end of tDCS sessions compared to the seizure frequency calculated in the pre-treatment period of reference.
Time Frame: Visit 4 (V4) - 4 weeks after the end of first cycle (each cycle is 10 days)
|
Seizure frequency counting after end of tDCS treatment compared to the baseline comparing Sham versus Active arms of the cross-over study.
|
Visit 4 (V4) - 4 weeks after the end of first cycle (each cycle is 10 days)
|
|
To obtain a significant seizure frequency change at the end of tDCS sessions compared to the seizure frequency calculated in the pre-treatment period of reference.
Time Frame: V5 - 8 weeks after the end of first cycle (each cycle is 10 days)
|
Seizure frequency counting after end of tDCS treatment compared to the baseline comparing Sham versus Active arms of the cross-over study.
|
V5 - 8 weeks after the end of first cycle (each cycle is 10 days)
|
|
To obtain a significant seizure frequency change at the end of tDCS sessions compared to the seizure frequency calculated in the pre-treatment period of reference.
Time Frame: V7 - 4 weeks after the end of the second cycle (each cycle is 10 days)
|
Seizure frequency counting after end of tDCS treatment compared to the baseline comparing Sham versus Active arms of the cross-over study.
|
V7 - 4 weeks after the end of the second cycle (each cycle is 10 days)
|
|
To obtain a significant seizure frequency change at the end of tDCS sessions compared to the seizure frequency calculated in the pre-treatment period of reference.
Time Frame: V8 - 8 weeks after the end of the second cycle (each cycle is 10 days)
|
Seizure frequency counting after end of tDCS treatment compared to the baseline comparing Sham versus Active arms of the cross-over study.
|
V8 - 8 weeks after the end of the second cycle (each cycle is 10 days)
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Evaluation of the number of responders (defined as patient with >50% of seizure reduction)
Time Frame: Visit 4 (V4) - 4 weeks after the end of first cycle (each cycle is 10 days)
|
Proportion of responders evaluated after active session of 10 days of tDCS treatment compared to the baseline comparing Sham versus Active arms of the cross-over study
|
Visit 4 (V4) - 4 weeks after the end of first cycle (each cycle is 10 days)
|
|
Evaluation of the number of responders (defined as patient with >50% of seizure reduction)
Time Frame: V5 - 8 weeks after the end of first cycle (each cycle is 10 days)
|
Proportion of responders evaluated after active session of 10 days of tDCS treatment compared to the baseline comparing Sham versus Active arms of the cross-over study
|
V5 - 8 weeks after the end of first cycle (each cycle is 10 days)
|
|
Evaluation of the number of responders (defined as patient with >50% of seizure reduction)
Time Frame: V7 - 4 weeks after the end of the second cycle (each cycle is 10 days)
|
Proportion of responders evaluated after active session of 10 days of tDCS treatment compared to the baseline comparing Sham versus Active arms of the cross-over study
|
V7 - 4 weeks after the end of the second cycle (each cycle is 10 days)
|
|
Evaluation of the number of responders (defined as patient with >50% of seizure reduction)
Time Frame: V8 - 8 weeks after the end of the second cycle (each cycle is 10 days)
|
Proportion of responders evaluated after active session of 10 days of tDCS treatment compared to the baseline comparing Sham versus Active arms of the cross-over study
|
V8 - 8 weeks after the end of the second cycle (each cycle is 10 days)
|
|
Evaluate the number of seizure-free patients
Time Frame: Visit 4 (V4) - 4 weeks after the end of first cycle (each cycle is 10 days)
|
Number of seizure-free patients after active session of 10 days of tDCS treatment compared to the baseline comparing Sham versus Active arms of the cross-over study
|
Visit 4 (V4) - 4 weeks after the end of first cycle (each cycle is 10 days)
|
|
Evaluate the number of seizure-free patients
Time Frame: V5 - 8 weeks after the end of first cycle (each cycle is 10 days)
|
Number of seizure-free patients after active session of 10 days of tDCS treatment compared to the baseline comparing Sham versus Active arms of the cross-over study
|
V5 - 8 weeks after the end of first cycle (each cycle is 10 days)
|
|
Evaluate the number of seizure-free patients
Time Frame: V7 - 4 weeks after the end of the second cycle (each cycle is 10 days)
|
Number of seizure-free patients after active session of 10 days of tDCS treatment compared to the baseline comparing Sham versus Active arms of the cross-over study
|
V7 - 4 weeks after the end of the second cycle (each cycle is 10 days)
|
|
Evaluate the number of seizure-free patients
Time Frame: V8 - 8 weeks after the end of the second cycle (each cycle is 10 days)
|
Number of seizure-free patients after active session of 10 days of tDCS treatment compared to the baseline comparing Sham versus Active arms of the cross-over study
|
V8 - 8 weeks after the end of the second cycle (each cycle is 10 days)
|
|
Quality of life after stimulation sessions with the baseline period
Time Frame: Visit 4 (V4) - 4 weeks after the end of first cycle (each cycle is 10 days)
|
Changes from baseline in the quality of life questionnaire (QOLIE 31 for adults and EFIQUACEE QOL for children) after the stimulation period
|
Visit 4 (V4) - 4 weeks after the end of first cycle (each cycle is 10 days)
|
|
Quality of life after stimulation sessions with the baseline period
Time Frame: V5 - 8 weeks after the end of first cycle (each cycle is 10 days)
|
Changes from baseline in the quality of life questionnaire (QOLIE 31 for adults and EFIQUACEE QOL for children) after the stimulation period
|
V5 - 8 weeks after the end of first cycle (each cycle is 10 days)
|
|
Quality of life after stimulation sessions with the baseline period
Time Frame: V7 - 4 weeks after the end of the second cycle (each cycle is 10 days)
|
Changes from baseline in the quality of life questionnaire (QOLIE 31 for adults and EFIQUACEE QOL for children) after the stimulation period
|
V7 - 4 weeks after the end of the second cycle (each cycle is 10 days)
|
|
Quality of life after stimulation sessions with the baseline period
Time Frame: V8 - 8 weeks after the end of the second cycle (each cycle is 10 days)
|
Changes from baseline in the quality of life questionnaire (QOLIE 31 for adults and EFIQUACEE QOL for children) after the stimulation period
|
V8 - 8 weeks after the end of the second cycle (each cycle is 10 days)
|
|
Evaluation of the change in seizure severity
Time Frame: Visit 4 (V4) - 4 weeks after the end of first cycle (each cycle is 10 days)
|
Changes in the scores of epilepsy severity (NHS3) (investigator evaluation)
|
Visit 4 (V4) - 4 weeks after the end of first cycle (each cycle is 10 days)
|
|
Evaluation of the change in seizure severity
Time Frame: V5 - 8 weeks after the end of first cycle (each cycle is 10 days)
|
Changes in the scores of epilepsy severity (NHS3) (investigator evaluation)
|
V5 - 8 weeks after the end of first cycle (each cycle is 10 days)
|
|
Evaluation of the change in seizure severity
Time Frame: V7 - 4 weeks after the end of the second cycle (each cycle is 10 days)
|
Changes in the scores of epilepsy severity (NHS3) (investigator evaluation)
|
V7 - 4 weeks after the end of the second cycle (each cycle is 10 days)
|
|
Evaluation of the change in seizure severity
Time Frame: V8 - 8 weeks after the end of the second cycle (each cycle is 10 days)
|
Changes in the scores of epilepsy severity (NHS3) (investigator evaluation)
|
V8 - 8 weeks after the end of the second cycle (each cycle is 10 days)
|
|
Changes in psychiatric comorbidities
Time Frame: Visit 4 (V4) - 4 weeks after the end of first cycle (each cycle is 10 days)
|
Changes from baseline in depression (NDDI-E) and anxiety (GAD-7) scores
|
Visit 4 (V4) - 4 weeks after the end of first cycle (each cycle is 10 days)
|
|
Changes in psychiatric comorbidities
Time Frame: V5 - 8 weeks after the end of first cycle (each cycle is 10 days)
|
Changes from baseline in depression (NDDI-E) and anxiety (GAD-7) scores
|
V5 - 8 weeks after the end of first cycle (each cycle is 10 days)
|
|
Changes in psychiatric comorbidities
Time Frame: V7 - 4 weeks after the end of the second cycle (each cycle is 10 days)
|
Changes from baseline in depression (NDDI-E) and anxiety (GAD-7) scores
|
V7 - 4 weeks after the end of the second cycle (each cycle is 10 days)
|
|
Changes in psychiatric comorbidities
Time Frame: V8 - 8 weeks after the end of the second cycle (each cycle is 10 days)
|
Changes from baseline in depression (NDDI-E) and anxiety (GAD-7) scores
|
V8 - 8 weeks after the end of the second cycle (each cycle is 10 days)
|
|
Safety assessment and possible side effects
Time Frame: Visit 4 (V4) - 4 weeks after the end of first cycle (each cycle is 10 days)
|
Percent of newly reported side-effect during and after the stimulation period
|
Visit 4 (V4) - 4 weeks after the end of first cycle (each cycle is 10 days)
|
|
Safety assessment and possible side effects
Time Frame: V5 - 8 weeks after the end of first cycle (each cycle is 10 days)
|
Percent of newly reported side-effect during and after the stimulation period
|
V5 - 8 weeks after the end of first cycle (each cycle is 10 days)
|
|
Safety assessment and possible side effects
Time Frame: V7 - 4 weeks after the end of the second cycle (each cycle is 10 days)
|
Percent of newly reported side-effect during and after the stimulation period
|
V7 - 4 weeks after the end of the second cycle (each cycle is 10 days)
|
|
Safety assessment and possible side effects
Time Frame: V8 - 8 weeks after the end of the second cycle (each cycle is 10 days)
|
Percent of newly reported side-effect during and after the stimulation period
|
V8 - 8 weeks after the end of the second cycle (each cycle is 10 days)
|
Other Outcome Measures
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Compare brain functional connectivity before and after tDCS treatment
Time Frame: V5 - 8 weeks after the end of first cycle (each cycle is 10 days)
|
Changes in functional connectivity measured by fMRI and EEG signal 4 weeks after the tDCS periods in comparison with baseline period
|
V5 - 8 weeks after the end of first cycle (each cycle is 10 days)
|
|
Evaluation of the impact of tDCS on interictal epileptic spikes (IESs)
Time Frame: Visit 4 (V4) - 4 weeks after the end of first cycle (each cycle is 10 days)
|
Change in the number of IESs per time unit after each tDCS session in comparison with baseline period
|
Visit 4 (V4) - 4 weeks after the end of first cycle (each cycle is 10 days)
|
|
Evaluation of the impact of tDCS on interictal epileptic spikes
Time Frame: Visit 4 (V4) - 4 weeks after the end of first cycle (each cycle is 10 days)
|
Change in localization and extent of brain areas involved in IESs before and after each tDCS session in comparison with baseline period
|
Visit 4 (V4) - 4 weeks after the end of first cycle (each cycle is 10 days)
|
|
Evaluation of the impact of tDCS on interictal epileptic spikes
Time Frame: V7 - 4 weeks after the end of the second cycle (each cycle is 10 days)
|
Change in localization and extent of brain areas involved in IESs before and after each tDCS session in comparison with baseline period
|
V7 - 4 weeks after the end of the second cycle (each cycle is 10 days)
|
|
Evaluation of the impact of tDCS on interictal epileptic spikes
Time Frame: Visit 4 (V4) - 4 weeks after the end of first cycle (each cycle is 10 days)
|
Changes in strength and density of functional links during IES before and after each tDCS session
|
Visit 4 (V4) - 4 weeks after the end of first cycle (each cycle is 10 days)
|
|
Evaluation of the impact of tDCS on interictal epileptic spikes
Time Frame: V7 - 4 weeks after the end of the second cycle (each cycle is 10 days)
|
Changes in strength and density of functional links during IES before and after each DCS session
|
V7 - 4 weeks after the end of the second cycle (each cycle is 10 days)
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Brain Diseases
- Central Nervous System Diseases
- Nervous System Diseases
- Drug Resistant Epilepsy
- Epilepsy
- Therapeutics
- Diagnostic Techniques and Procedures
- Diagnosis
- Behavioral Disciplines and Activities
- Diagnostic Techniques, Neurological
- Electric Stimulation Therapy
- Convulsive Therapy
- Psychiatric Somatic Therapies
- Electroshock
- Psychological Techniques
- Electrodiagnosis
- Transcranial Direct Current Stimulation
- Electroencephalography
Other Study ID Numbers
Other Study ID Numbers
- RCAPHM23_0074
- ID-RCB (Other Identifier: 2023-A01756-39)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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