Daniel San-Juan1, León Morales-Quezada2, Adolfo Josué Orozco Garduño3, Mario Alonso-Vanegas4, Maricarmen Fernández González-Aragón3, Dulce Anabel Espinoza López3, Rafael Vázquez Gregorio3, David J Anschel5, Felipe Fregni2. 1. Neurophysiology Department, National Institute of Neurology and Neurosurgery "Manuel Velasco Suárez", Av. Insurgentes Sur 3877, Col. La Fama, Tlalpan, México D.F. 14269, Mexico. Electronic address: pegaso31@yahoo.com. 2. Laboratory of Neuromodulation, Department of Physical Medicine & Rehabilitation, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, 300 1st Ave, Charlestown, MA 02129, USA. 3. Neurophysiology Department, National Institute of Neurology and Neurosurgery "Manuel Velasco Suárez", Av. Insurgentes Sur 3877, Col. La Fama, Tlalpan, México D.F. 14269, Mexico. 4. Neurosurgery Department, National Institute of Neurology and Neurosurgery "Manuel Velasco Suárez", Av. Insurgentes Sur 3877, Col. La Fama, Tlalpan, México D.F. 14269, Mexico. 5. Comprehensive Epilepsy Center of Long Island, St. Charles Hospital, 200 Belle Terre Rd., Port Jefferson, NY 11777, USA.
Abstract
BACKGROUND: Transcranial direct current stimulation (tDCS) is an emerging non-invasive neuromodulation therapy in epilepsy with conflicting results in terms of efficacy and safety. OBJECTIVE: Review the literature about the efficacy and safety of tDCS in epilepsy in humans and animals. METHODS: We searched studies in PubMed, MedLine, Scopus, Web of Science and Google Scholar (January 1969 to October 2013) using the keywords 'transcranial direct current stimulation' or 'tDCS' or 'brain polarization' or 'galvanic stimulation' and 'epilepsy' in animals and humans. Original articles that reported tDCS safety and efficacy in epileptic animals or humans were included. Four review authors independently selected the studies, extracted data and assessed the methodological quality of the studies using the recommendations of the Cochrane Handbook for Systematic Reviews of Interventions, PRISMA guidelines and Jadad Scale. A meta-analysis was not possible due to methodological, clinical and statistical heterogeneity of included studies. RESULTS: We analyzed 9 articles with different methodologies (3 animals/6 humans) with a total of 174 stimulated individuals; 109 animals and 65 humans. In vivo and in vitro animal studies showed that direct current stimulation can successfully induce suppression of epileptiform activity without neurological injury and 4/6 (67%) clinical studies showed an effective decrease in epileptic seizures and 5/6 (83%) reduction of inter-ictal epileptiform activity. All patients tolerated tDCS well. CONCLUSIONS: tDCS trials have demonstrated preliminary safety and efficacy in animals and patients with epilepsy. Further larger studies are needed to define the best stimulation protocols and long-term follow-up.
BACKGROUND: Transcranial direct current stimulation (tDCS) is an emerging non-invasive neuromodulation therapy in epilepsy with conflicting results in terms of efficacy and safety. OBJECTIVE: Review the literature about the efficacy and safety of tDCS in epilepsy in humans and animals. METHODS: We searched studies in PubMed, MedLine, Scopus, Web of Science and Google Scholar (January 1969 to October 2013) using the keywords 'transcranial direct current stimulation' or 'tDCS' or 'brain polarization' or 'galvanic stimulation' and 'epilepsy' in animals and humans. Original articles that reported tDCS safety and efficacy in epileptic animals or humans were included. Four review authors independently selected the studies, extracted data and assessed the methodological quality of the studies using the recommendations of the Cochrane Handbook for Systematic Reviews of Interventions, PRISMA guidelines and Jadad Scale. A meta-analysis was not possible due to methodological, clinical and statistical heterogeneity of included studies. RESULTS: We analyzed 9 articles with different methodologies (3 animals/6 humans) with a total of 174 stimulated individuals; 109 animals and 65 humans. In vivo and in vitro animal studies showed that direct current stimulation can successfully induce suppression of epileptiform activity without neurological injury and 4/6 (67%) clinical studies showed an effective decrease in epilepticseizures and 5/6 (83%) reduction of inter-ictal epileptiform activity. All patients tolerated tDCS well. CONCLUSIONS: tDCS trials have demonstrated preliminary safety and efficacy in animals and patients with epilepsy. Further larger studies are needed to define the best stimulation protocols and long-term follow-up.
Authors: A Antal; I Alekseichuk; M Bikson; J Brockmöller; A R Brunoni; R Chen; L G Cohen; G Dowthwaite; J Ellrich; A Flöel; F Fregni; M S George; R Hamilton; J Haueisen; C S Herrmann; F C Hummel; J P Lefaucheur; D Liebetanz; C K Loo; C D McCaig; C Miniussi; P C Miranda; V Moliadze; M A Nitsche; R Nowak; F Padberg; A Pascual-Leone; W Poppendieck; A Priori; S Rossi; P M Rossini; J Rothwell; M A Rueger; G Ruffini; K Schellhorn; H R Siebner; Y Ugawa; A Wexler; U Ziemann; M Hallett; W Paulus Journal: Clin Neurophysiol Date: 2017-06-19 Impact factor: 3.708
Authors: Jorge Leite; Leon Morales-Quezada; Sandra Carvalho; Aurore Thibaut; Deniz Doruk; Chiun-Fan Chen; Steven C Schachter; Alexander Rotenberg; Felipe Fregni Journal: Int J Neural Syst Date: 2017-04-11 Impact factor: 5.866
Authors: Sameer C Dhamne; Dana Ekstein; Zhihong Zhuo; Roman Gersner; David Zurakowski; Tobias Loddenkemper; Alvaro Pascual-Leone; Frances E Jensen; Alexander Rotenberg Journal: Ann Clin Transl Neurol Date: 2015-07-03 Impact factor: 4.511