Transcranial direct current stimulation reduces seizure frequency in patients with refractory focal epilepsy: A randomized, double-blind, sham-controlled, and three-arm parallel multicenter study
Dongju Yang, Qun Wang, Cuiping Xu, Fang Fang, Jingjing Fan, Liping Li, Qiaoyi Du, Ruihua Zhang, Ye Wang, Yicong Lin, Zhaoyang Huang, Hongmei Wang, Chunhong Chen, Qinlan Xu, Yue Wang, Yi Zhang, Zhang Zhang, Xin Zhao, Xuan Zhao, Ting Li, Chunyan Liu, Yulian Niu, Qihui Zhou, Qilin Zhou, Yiran Duan, Xiao Liu, Tingting Yu, Qing Xue, Jing Li, Xiaona Dai, Jiaqi Han, Changhong Ren, Huini Xu, Na Li, Jishui Zhang, Na Xu, Kun Yang, Yuping Wang, Dongju Yang, Qun Wang, Cuiping Xu, Fang Fang, Jingjing Fan, Liping Li, Qiaoyi Du, Ruihua Zhang, Ye Wang, Yicong Lin, Zhaoyang Huang, Hongmei Wang, Chunhong Chen, Qinlan Xu, Yue Wang, Yi Zhang, Zhang Zhang, Xin Zhao, Xuan Zhao, Ting Li, Chunyan Liu, Yulian Niu, Qihui Zhou, Qilin Zhou, Yiran Duan, Xiao Liu, Tingting Yu, Qing Xue, Jing Li, Xiaona Dai, Jiaqi Han, Changhong Ren, Huini Xu, Na Li, Jishui Zhang, Na Xu, Kun Yang, Yuping Wang
Abstract
Background: Transcranial direct current stimulation (tDCS) has been explored in epilepsy with limited samples, varied parameters, and inconclusive results. We aimed to study the efficacy of tDCS for patients with refractory focal epilepsy.
Method: We conducted a randomized, double-blind, sham-controlled, and three-arm (Group 1 (sham), Group 2 (20-min), and Group 3 (2 × 20-min)) tDCS parallel multicenter study. The primary outcome measurement was seizure frequencies (SFs). The study consisted of 28-days baseline, 14-days treatment, and 56-days follow-up. The cathode was placed over the epileptogenic focus, and the current intensity was 2 mA. The generalized estimating equations model, one-way analysis of variance, chi-square and Kruskal-Wallis test were used for analysis.
Results: Of the 82 enrolled patients, 70 patients were included for final analysis (Group 1, n = 21; Group 2, n = 24; and Group 3, n = 25). There was a significant reduction in SFs for both active tDCS groups compared with the sham group. Patients in Group 2 showed a significantly 50.73-21.91% greater reduction in SFs that lasted for 4 weeks (p = 0.008-0.060). Patients in Group 3 showed a significantly 63.19-49.79% greater reduction in SFs compared with the sham group that lasted for 5 weeks (p = 0.011-0.045). Patients in Group 3 had a 64.98-66.32% greater reduction in SFs at W9-W10, when compared with Group 2 (p = 0.021-0.022).
Conclusion: Fourteen consecutive days tDCS significantly decreased SFs in patients with refractory focal epilepsy, with 2 × 20-min daily stimulation protocol being superior to 20-min daily stimulation protocol.
Keywords: Interval between sessions; Refractory focal epilepsy; Repeated sessions; Transcranial direct current stimulation (tDCS).
Copyright © 2019. Published by Elsevier Inc.
Source: PubMed