Transcranial Direct Current Stimulation for Treatment of Refractory Childhood Focal Epilepsy
Transcranial Direct Current Stimulation for Treatment of Refractory Childhood Focal Epilepsy
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DOI：
10.1016/j.brs.2013.01.009
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发表时间：
2013-07-01
影响因子：
7.7
通讯作者：
Auvichayapat, Paradee
中科院分区：
文献类型：
--
作者：
Auvichayapat, Narong;Rotenberg, Alexander;Auvichayapat, Paradee
背景：经颅直流电刺激是一种抑制局部皮质兴奋性的非侵入性脑刺激方法。我们研究了阴极tdcs治疗儿童难治性局灶性癫痫的安全性和抗癫痫疗效。方法：本研究包括三个阶段：1)为期4周的治疗前监测期，包括生命体征、EEG、癫痫日记和基线生活质量(QOL)问卷；2)1 mA阴极tDCS治疗20分钟，阴极位于癫痫灶上方，对侧肩部阳极；3)刺激后即刻、24、48小时和4周的随访，持续的癫痫日记和癫痫放电计数；刺激后4周复查生活质量问卷。患者随机接受单次治疗1 mA，20分钟。结果：36例6~15岁的局灶性癫痫患儿，其中27例为活动期，9例为假手术组。所有患者对tdcs耐受性良好。未发生严重不良事件。积极的tdcs治疗可显著减少tdcs后即刻、24和48h的癫痫放电频率。治疗4周后，癫痫发作频率也有小幅下降(临床上可以忽略，但有统计学意义)。结论：单次阴极tDCs治疗可改善48 h内儿童癫痫的脑电异常，且耐受性良好。(C)2013 Elsevier Inc.保留所有权利。
Background: Cathodal transcranial direct current stimulation (tDCS) is a noninvasive brain stimulation method for suppressing regional cortical excitability. We examine the safety and antiepileptic efficacy of cathodal tDCS in children with refractory focal epilepsy. Although a prior cathodal tDCS trial in adults with epilepsy revealed EEG improvement, neither the antiepileptic potential nor the safety and tolerability of tDCS has been tested in children.Method: The study consisted of three phases: 1) a 4-week pre-treatment monitoring period with vital sign measures, EEG, seizure diary, and baseline quality of life (QOL) questionnaire; 2) a single treatment with 1 mA cathodal tDCS for 20 min with cathode positioned over the seizure focus and anode on the contralateral shoulder; 3) follow-ups immediately after stimulation, and at 24, 48 h, and 4 weeks after tDCS with continued seizure diary and epileptic discharge counts on EEG; the QOL questionnaire was also repeated 4 weeks after stimulation. Patients were randomized to receive either single session active or sham tDCS 1 mA, 20 min.Results: Thirty six children (6-15 years) with focal epilepsy were enrolled, 27 in active and 9 in sham group. All patients tolerated tDCS well. No serious adverse events occurred. Active tDCS treatment was associated with significant reductions in epileptic discharge frequency immediately and 24 and 48 h after tDCS. Four weeks after treatment, a small (clinically negligible but statistically significant) decrease in seizure frequency was also detected.Conclusion: A single session of cathodal tDCS improves epileptic EEG abnormalities for 48 h and is well-tolerated in children. (C) 2013 Elsevier Inc. All rights reserved.