Brain Stimulation (Jan 2020)
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
Affiliations
- Dongju Yang
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China; Beijing Key Laboratory of Neuromodulation, Beijing, China
- Qun Wang
- Beijing Key Laboratory of Neuromodulation, Beijing, China; Department of Neurology, Beijing Tiantan Hosipital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing, 100070, China; Center of Epilepsy, Beijing Institute for Brain Disorders, Capital Medical University, Beijing, China
- Cuiping Xu
- Department of Functional Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
- Fang Fang
- Department of Neurology, Beijing Children's Hospital, Capital Medical University, Beijing, China
- Jingjing Fan
- Department of Neurology, Beijing Tiantan Hosipital, Capital Medical University, Beijing, China
- Liping Li
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China; Beijing Key Laboratory of Neuromodulation, Beijing, China
- Qiaoyi Du
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China; Beijing Key Laboratory of Neuromodulation, Beijing, China
- Ruihua Zhang
- Department of Geriatric Medicine, Beijing Luhe Hospital, Affiliated to Capital Medical University, China
- Ye Wang
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China; Beijing Key Laboratory of Neuromodulation, Beijing, China
- Yicong Lin
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China; Beijing Key Laboratory of Neuromodulation, Beijing, China
- Zhaoyang Huang
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China; Beijing Key Laboratory of Neuromodulation, Beijing, China
- Hongmei Wang
- Department of Neurology, Beijing Children's Hospital, Capital Medical University, Beijing, China
- Chunhong Chen
- Department of Neurology, Beijing Children's Hospital, Capital Medical University, Beijing, China
- Qinlan Xu
- Department of Neurology, Beijing Tiantan Hosipital, Capital Medical University, Beijing, China
- Yue Wang
- Department of Neurology, Beijing Tiantan Hosipital, Capital Medical University, Beijing, China
- Yi Zhang
- Department of Neurology, Beijing Children's Hospital, Capital Medical University, Beijing, China
- Zhang Zhang
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China; Beijing Key Laboratory of Neuromodulation, Beijing, China
- Xin Zhao
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China; Beijing Key Laboratory of Neuromodulation, Beijing, China
- Xuan Zhao
- Department of Pediatric, Xuanwu Hospital, Capital Medical University, Beijing, China
- Ting Li
- Department of Pediatric, Xuanwu Hospital, Capital Medical University, Beijing, China
- Chunyan Liu
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China; Beijing Key Laboratory of Neuromodulation, Beijing, China; Department of Neurology, Beijing Luhe Hospital, Affiliated to Capital Medical University, China
- Yulian Niu
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China; Beijing Key Laboratory of Neuromodulation, Beijing, China
- Qihui Zhou
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China; Beijing Key Laboratory of Neuromodulation, Beijing, China
- Qilin Zhou
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China; Beijing Key Laboratory of Neuromodulation, Beijing, China
- Yiran Duan
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China; Beijing Key Laboratory of Neuromodulation, Beijing, China
- Xiao Liu
- Department of Neurology, Beijing Tiantan Hosipital, Capital Medical University, Beijing, China
- Tingting Yu
- Department of Neurology, Beijing Tiantan Hosipital, Capital Medical University, Beijing, China
- Qing Xue
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China; Beijing Key Laboratory of Neuromodulation, Beijing, China
- Jing Li
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China; Beijing Key Laboratory of Neuromodulation, Beijing, China
- Xiaona Dai
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China; Beijing Key Laboratory of Neuromodulation, Beijing, China
- Jiaqi Han
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China; Beijing Key Laboratory of Neuromodulation, Beijing, China
- Changhong Ren
- Department of Neurology, Beijing Children's Hospital, Capital Medical University, Beijing, China
- Huini Xu
- Department of Neurology, Beijing Children's Hospital, Capital Medical University, Beijing, China
- Na Li
- Department of Neurology, Beijing Children's Hospital, Capital Medical University, Beijing, China
- Jishui Zhang
- Department of Mental Health, Beijing Children's Hospital, Capital Medical University, Beijing, China
- Na Xu
- Department of Geriatric Medicine, Beijing Luhe Hospital, Affiliated to Capital Medical University, China
- Kun Yang
- Department of Evidence-Based Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China
- Yuping Wang
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China; Beijing Key Laboratory of Neuromodulation, Beijing, China; Center of Epilepsy, Beijing Institute for Brain Disorders, Capital Medical University, Beijing, China; Corresponding author. Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.
- Journal volume & issue
-
Vol. 13,
no. 1
pp. 109 – 116
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.
