A controlled clinical trial of cathodal DC polarization in patients with refractory epilepsy
A controlled clinical trial of cathodal DC polarization in patients with refractory epilepsy
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DOI：
10.1111/j.1528-1167.2006.00426.x
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发表时间：
2006-02-01
期刊：
影响因子：
5.6
通讯作者：
Pascual-Leone, A
中科院分区：
文献类型：
--
作者：
Fregni, F;Thome-Souza, S;Pascual-Leone, A
目的：研究阴极直流极化在难治性癫痫和皮质发育畸形（MCDs）患者中的作用，以癫痫发作频率和癫痫样EEG放电为指标。方法：19例MCDs和难治性癫痫患者接受了一次针对致痫灶的直流极化（20 min，1 mA）。癫痫样放电（ED）的EEG和癫痫发作的数量进行了测量之前（基线），之后立即，15和30天后，无论是假或主动直流极化。治疗后癫痫发作频率与基线比较。与假DC极化相比，主动DC极化与癫痫样放电次数显著减少相关[平均艾德减少-64.3%（95% CI，-122.5%至-6.0%）（活性治疗组）和-5.8%（95% CI，-26.8%至15.2%）（假治疗组）]。一种趋势（p = 0.06）与假治疗相比，活性治疗后癫痫发作频率降低[平均癫痫发作频率降低-44.0%（95% CI，-95.0%至7.1%），活性治疗组和-11.1%（95%CI，假治疗组为-22.2%至44.4%）。结论：该随机对照研究表明，阴极DC极化不会诱导癫痫发作，并且在患有难治性癫痫和MCD的患者中耐受良好。此外，结果表明，该技术可能具有基于临床和电生理标准的抗癫痫作用。
Purpose: To study the effects of cathodal DC polarization in patients with refractory epilepsy and malformations of cortical development (MCDs) as indexed by seizure frequency and epileptiform EEG discharges.Methods: Nineteen patients with MCDs and refractory epilepsy underwent one session of DC polarization (20 min, 1 mA) targeting the epileptogenic focus. The number of epileptiform discharges (EDs) in the EEG and seizures were measured before (baseline), immediately after, and 15 and 30 days after either sham or active DC polarization. Seizure frequency after the treatment was compared with baseline.Results: Active compared with sham DC polarization was associated with a significant reduction in the number of epileptiform discharges [mean ED reduction of -64.3% (95% CI, -122.5% to -6.0%) for the active treatment group and -5.8% (95% CI, -26.8% to 15.2%) for the sham treatment group]. A trend (p = 0.06) was noted for decrease in seizure frequency after active compared with sham treatment [mean seizure frequency decrease of -44.0% (95% CI, -95.0% to 7.1%) for the active treatment group and -11.1% (95% CI, -22.2% to 44.4%) for the sham treatment group].Conclusions: This randomized, controlled study shows that cathodal DC polarization does not induce seizures and is well tolerated in patients with refractory epilepsy and MCDs. Furthermore, the results suggest that this technique might have an antiepileptic effect based on clinical and electrophysiological criteria.