Value of transcranial direct current polarisation in people with focal drug resistant epilepsy

Abstract

Drug resistant epilepsy (DRE) accounts for about one third of people with epilepsy (PWE), even after introduction of more than twenty antiepileptic drugs. Accordingly, Cathodal transcranial direct current stimulation (Cathodal tDCS) considered as a neuromodulation protocol which is emerging to reduce cortical excitability and consider as potential antiepileptic therapy. To investigate whether Cathodal tDCS can modify seizure frequency in People with drug resistant focal epilepsy, assessed by clinical evaluation, seizure diary and electroencephalography (EEG). A randomized, double blind, placebo controlled clinical trial on 20 PWE diagnosed with focal DRE were enrolled in our study. The patients were randomized into 2 groups. First Group received real 5-day sessions of cathodal tDCS over the area of most frequent interictal epileptiform discharges (ED) or the area of suspected ictal onset. The second group received sham sessions. Outcome indicators were baseline and post sessions (4 weeks) seizure diary and ED which were counted per hour. Patients subgroups were matched as regard the baseline characteristics. The percentage reduction of ED was greater for real stimulation versus the placebo group (p = 0.0124). also, the percentagereduction of seizure frequency was greater for real stimulation group versus the placebo group (p = 0.0308). Our study shows that cathodal tDCS is a promising therapeutic tool for short term seizure reduction in chronic drug resistant focal epilepsy patients.