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Cathodal transcranial direct current stimulation reduces seizure frequency in adults with drug-resistant temporal lobe epilepsy: A sham controlled study
| Content Provider | Semantic Scholar |
|---|---|
| Author | Assenza, Giovanni Campana, Chiara Assenza, Federica Pellegrino, Giovanni Lazzaro, Vincenzo Di |
| Copyright Year | 2017 |
| Abstract | One-third of epilepsy patients develop drug resistance, and half of them can benefit from the surgical removal of epileptic focus (EF). Neuromodulation represents the only hope to ameliorate the quality of life of the remaining patients [1]. Cathodal transcranial direct current stimulation (ctDCS) is a techniques able to noninvasively inhibit cortical excitability [2], which is abnormally increased in epilepsy [3]. Preliminary results of ctDCS of Epileptic focus (EF) of focal drug-resistant epilepsy (DRE) are promising [4], but several technical issues could be optimized to achieve a clinically relevant effect. In this proof-of-principle study, we evaluated the efficacy of a novel symmetric ctDCS approach vs sham-tDCS in temporal lobe DRE. We enrolled ten patients affected by temporal lobe DRE (4 males; 42 ± 15.7 years old; 4 symptomatic and 6 cryptogenic; 5 right EF, 5 left EF). Inclusion criteria: Age>18 years; temporal DRE; mean seizure frequency (SF) 2/week in the last 3 months; patients or caregivers are able to reliably provide seizure diary. Exclusion criteria: psychogenic seizures; multifocality; major psychiatric or neurological disorders other than epilepsy; electrical medical devices. All patients signed a written informed consent approved by local ethical committee. Clinical data are summarized in supplementary Table e1. We designed a double-blind, randomized, sham-controlled, crossover, monocentric study. After a week of seizure diary (days 1e7), patients were randomized to either first-ctDCS or first-sham-ctDCS treatment. On day 8, patients underwent the assigned stimulation. On day 38, patients underwent the single-session opposite stimulation. 7 days after the second session, the study was concluded. Patients were asked to not modify their therapy during the entire study. ctDCS was delivered with a battery-driven stimulator (Schneider Electronic, Gleichen, Germany-Newronika) connected to a saline-soaked pair of surface sponge conductive electrodes (5 cm 7 cm). The cathode was placed over the EF, localized by means of EEG interictal and ictal activity, and the anode over the contralateral homologous region. The real stimulation consisted of 20-min 1mA ctDCS. The sham-ctDCS stimulation consisted of delivering current for only 10 s, both at the beginning and at the end of the 20-min session [5]. Immediately before and after stimulation, a one-hour resting state closed-eyes 19-electrodes video-EEG recording was acquired. EEG was then evaluated for the presence and duration of interictal epileptiform activity (EA). EA was then described as follows: EA |
| Starting Page | 333 |
| Ending Page | 335 |
| Page Count | 3 |
| File Format | PDF HTM / HTML |
| DOI | 10.1016/j.brs.2016.12.005 |
| PubMed reference number | 28017320 |
| Journal | Medline |
| Volume Number | 10 |
| Alternate Webpage(s) | https://api.elsevier.com/content/article/pii/S1935861X16303874 |
| Alternate Webpage(s) | https://www.sciencedirect.com/science/article/pii/S1935861X16303874?dgcid=api_sd_search-api-endpoint |
| Alternate Webpage(s) | https://doi.org/10.1016/j.brs.2016.12.005 |
| Journal | Brain Stimulation |
| Language | English |
| Access Restriction | Open |
| Content Type | Text |
| Resource Type | Article |
