Transcranial Electrical Stimulation Targeting the Cerebellum for the Treatment of Refractory Temporal Lobe Epilepsy
A Study on the Efficacy and Mechanism of Targeted Cerebellar Transcranial Electrical Stimulation for the Treatment of Refractory Temporal Lobe Epilepsy: A Single-center, Observational Study.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: guan xiao, master
- Phone Number: 18392320919
- Email: guanxiao0223@163.com
Study Locations
-
-
Shannxi
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Xi'an, Shannxi, China
- Recruiting
- Xijing Hospital of Air Force Military Medical University
-
Contact:
- guan xiao, master
- Phone Number: 18392320919
- Email: guanxiao0223@163.com
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Age between 18 and 65 years old;
- Diagnosed with refractory temporal lobe epilepsy as defined by the International League Against Epilepsy (ILAE) (failure to achieve seizure-free status after adequate trials of two appropriate antiepileptic drugs);
- Duration of epilepsy is at least 2 years, with a seizure frequency of at least 2 times per 4 weeks in the three months before enrollment;
- Taking two or more antiepileptic drugs, and continuing the same medication treatment plan during the trial period;
- Capable of cooperating to complete the treatment and related examination items;
- The patient and family members fully understand and voluntarily sign the informed consent form.
Exclusion Criteria:
- Scalp skin damage (including skin diseases or damage in the area where electrodes are applied);
- Psychogenic epilepsy or pseudo-epilepsy;
- Concurrent severe infections, cerebrovascular diseases, malignant tumors, or other diseases with severe dysfunction of major organs such as the heart, liver, and kidneys, or with mental disorders;
- Presence of any implanted devices or instruments (such as cardiac pacemakers, deep brain stimulators, cochlear implants, and vagus nerve stimulators, etc.);
- History of head trauma or other brain-related diseases;
- Pregnant or breastfeeding women;
- Participation in other clinical trials at the same time;
- Changes in medication treatment plan during baseline, treatment, or follow-up period;
- Withdrawal of informed consent by the patient or family members.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Transcranial Alternating Current Stimulation Intervention
Patients with refractory TLE recruited for the study will undergo a 6-week treatment with the tACS (transcranial alternating current stimulation) protocol, which involves a 2mA current at 10Hz for 20 minutes on both sides.
The treatment schedule is 5 days of treatment followed by 2 days of rest, and then another 5 days of treatment, with a weekly reinforcement treatment, for a total of 14 sessions.
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Transcranial Alternating Current Stimulation
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Compared to baseline, the reduction rate of epileptic seizure frequency
Time Frame: baseline, 10 weeks,14 weeks after treatment
|
((post-treatment - baseline) / baseline).
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baseline, 10 weeks,14 weeks after treatment
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Quality of Life in Epilepsy-31 (QOLIE-31) Questionnaire
Time Frame: baseline, 10 weeks,14 weeks after treatment
|
The scoring method for the QOLIE-31 Questionnaire involves several key steps, as follows:1.Initial Score Calculation: the raw scores for each item on the scale can be converted to a range of 0 to 100;2.Weighted Scoring:the transformed scores are multiplied by their respective weights;3.Total Score Calculation:all the weighted scores are added together to obtain the total score.
Total Score=(Emotional Symptoms Score×25+Psychological Function Score×25+Social Function Score×20+Life Domains Score×17+Additional Items Score×13)/5 In the QOLIE-31 scoring system, a higher score indicates a better quality of life for individuals with epilepsy.
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baseline, 10 weeks,14 weeks after treatment
|
|
MRI measures
Time Frame: baseline,2weeks,14weeks after treatment
|
This study primarily applied resting-state blood oxygen level dependent functional magnetic resonance imaging (BOLD) and magnetic resonance diffusion tensor imaging (DTI) techniques to evaluate the changes in functional connectivity of the cerebellum in healthy subjects and patients before and after two weeks of transcranial electrical stimulation (TES) treatment, as well as the changes in the cerebellar cortical white matter fiber bundles two months after treatment.
ALFF and ReHo analyses can reveal the characteristics of local neural activity in the brain during the resting state, and abnormal brain regions can serve as regions of interest (ROIs) for subsequent functional connectivity analysis.
Additionally, the flow of cerebrospinal fluid (CSF) can be measured to reflect the functional state of the glymphatic system, which can be used to assess the therapeutic effects and the impact on lymphatic drainage function.
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baseline,2weeks,14weeks after treatment
|
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electroencephalogram(EEG)
Time Frame: baseline,2weeks after treatment
|
The changes in EEG will constitute secondary research outcomes.
EEG can evaluate the changes in brain functional connectivity in patients before and after transcranial electrical stimulation (TES) treatment.
In addition, the alterations in the power spectrum of each frequency band, including delta, alpha, beta, theta, low gamma, and high gamma, will also be measured before and after TES treatment.
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baseline,2weeks after treatment
|
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Near-Infrared Spectroscopy (NIRS) Brain Functional Imaging
Time Frame: baseline,2weeks after treatment
|
Near-Infrared Spectroscopy (NIRS) Brain Functional Imaging can assess the changes in brain function of patients before and after transcranial electrical stimulation (TES) treatment.Changes in brain functional connectivity as measured by near-infrared spectroscopy (fNIRS) imaging before and after transcranial electrical stimulation treatment.
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baseline,2weeks after treatment
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Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Study Chair: Jiang Wen, Xijing Hospital of Air Force Military Medical University
Publications and helpful links
General Publications
- Fregni F, Thome-Souza S, Nitsche MA, Freedman SD, Valente KD, Pascual-Leone A. A controlled clinical trial of cathodal DC polarization in patients with refractory epilepsy. Epilepsia. 2006 Feb;47(2):335-42. doi: 10.1111/j.1528-1167.2006.00426.x.
- Antal A, Boros K, Poreisz C, Chaieb L, Terney D, Paulus W. Comparatively weak after-effects of transcranial alternating current stimulation (tACS) on cortical excitability in humans. Brain Stimul. 2008 Apr;1(2):97-105. doi: 10.1016/j.brs.2007.10.001. Epub 2007 Dec 3.
- Tergau F, Naumann U, Paulus W, Steinhoff BJ. Low-frequency repetitive transcranial magnetic stimulation improves intractable epilepsy. Lancet. 1999 Jun 26;353(9171):2209. doi: 10.1016/S0140-6736(99)01301-X. No abstract available.
- Tavakoli AV, Yun K. Transcranial Alternating Current Stimulation (tACS) Mechanisms and Protocols. Front Cell Neurosci. 2017 Sep 1;11:214. doi: 10.3389/fncel.2017.00214. eCollection 2017.
- Chen R, Spencer DC, Weston J, Nolan SJ. Transcranial magnetic stimulation for the treatment of epilepsy. Cochrane Database Syst Rev. 2016 Aug 11;(8):CD011025. doi: 10.1002/14651858.CD011025.pub2.
- Liu A, Voroslakos M, Kronberg G, Henin S, Krause MR, Huang Y, Opitz A, Mehta A, Pack CC, Krekelberg B, Berenyi A, Parra LC, Melloni L, Devinsky O, Buzsaki G. Immediate neurophysiological effects of transcranial electrical stimulation. Nat Commun. 2018 Nov 30;9(1):5092. doi: 10.1038/s41467-018-07233-7.
- Devinsky O, Vezzani A, O'Brien TJ, Jette N, Scheffer IE, de Curtis M, Perucca P. Epilepsy. Nat Rev Dis Primers. 2018 May 3;4:18024. doi: 10.1038/nrdp.2018.24.
- Zoghi M, O'Brien TJ, Kwan P, Cook MJ, Galea M, Jaberzadeh S. Cathodal transcranial direct-current stimulation for treatment of drug-resistant temporal lobe epilepsy: A pilot randomized controlled trial. Epilepsia Open. 2016 Oct 17;1(3-4):130-135. doi: 10.1002/epi4.12020. eCollection 2016 Dec.
- Theodore WH, Fisher RS. Brain stimulation for epilepsy. Lancet Neurol. 2004 Feb;3(2):111-8. doi: 10.1016/s1474-4422(03)00664-1. Erratum In: Lancet Neurol. 2004 Jun;3(6):332.
- San-Juan D, Espinoza-Lopez DA, Vazquez-Gregorio R, Trenado C, Aragon MF, Perez-Perez D, Hernandez-Ruiz A, Anschel DJ. A pilot randomized controlled clinical trial of Transcranial Alternating Current Stimulation in patients with multifocal pharmaco-resistant epilepsy. Epilepsy Behav. 2022 May;130:108676. doi: 10.1016/j.yebeh.2022.108676. Epub 2022 Mar 30.
- San-Juan D, Sarmiento CI, Hernandez-Ruiz A, Elizondo-Zepeda E, Santos-Vazquez G, Reyes-Acevedo G, Zuniga-Gazcon H, Zamora-Jarquin CM. Transcranial Alternating Current Stimulation: A Potential Risk for Genetic Generalized Epilepsy Patients (Study Case). Front Neurol. 2016 Nov 28;7:213. doi: 10.3389/fneur.2016.00213. eCollection 2016.
- Mogul DJ, van Drongelen W. Electrical control of epilepsy. Annu Rev Biomed Eng. 2014 Jul 11;16:483-504. doi: 10.1146/annurev-bioeng-071813-104720.
- Elyamany O, Leicht G, Herrmann CS, Mulert C. Transcranial alternating current stimulation (tACS): from basic mechanisms towards first applications in psychiatry. Eur Arch Psychiatry Clin Neurosci. 2021 Feb;271(1):135-156. doi: 10.1007/s00406-020-01209-9. Epub 2020 Nov 19.
- Berenyi A, Belluscio M, Mao D, Buzsaki G. Closed-loop control of epilepsy by transcranial electrical stimulation. Science. 2012 Aug 10;337(6095):735-7. doi: 10.1126/science.1223154.
- Streng ML, Krook-Magnuson E. The cerebellum and epilepsy. Epilepsy Behav. 2021 Aug;121(Pt B):106909. doi: 10.1016/j.yebeh.2020.106909. Epub 2020 Feb 5.
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
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
Other Study ID Numbers
Other Study ID Numbers
- KY20232387
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
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