A Controlled Clinical Trial of Cathodal DC Polarization in Patients with Refractory Epilepsy
Article first published online: 24 FEB 2006
Volume 47, Issue 2, pages 335–342, February 2006
How to Cite
Fregni, F., Thome-Souza, S., Nitsche, M. A., Freedman, S. D., Valente, K. D. and Pascual-Leone, A. (2006), A Controlled Clinical Trial of Cathodal DC Polarization in Patients with Refractory Epilepsy. Epilepsia, 47: 335–342. doi: 10.1111/j.1528-1167.2006.00426.x
- Issue published online: 24 FEB 2006
- Article first published online: 24 FEB 2006
- Accepted October 9, 2005.
- Cathodal DC polarization;
- Transcranial direct current stimulation;
- Malformations of cortical development
Summary: 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.