Liebetanz David, Klinker Florian, Hering Diana, Koch Reinhard, Nitsche Michael A, Potschka Heidrun, Löscher Wolfgang, Paulus Walter, Tergau Frithjof
Department of Clinical Neurophysiology, Georg-August-University, Göttingen, Germany.
Epilepsia. 2006 Jul;47(7):1216-24. doi: 10.1111/j.1528-1167.2006.00539.x.
Weak direct currents induce lasting alterations of cortical excitability in animals and humans, which are controlled by polarity, duration of stimulation, and current strength applied. To evaluate its anticonvulsant potential, transcranial direct current stimulation (tDCS) was tested in a modified cortical ramp-stimulation model of focal epilepsy.
The threshold for localized seizure activity (TLS) was determined in freely moving rats by applying a single train of rising bipolar pulses through a unilateral epicranial electrode. After tDCS, TLS was determined repeatedly for 120 min at intervals of 15 min. The first group of animals received two sessions of cathodal tDCS at 100 microA, one for 30 and one for 60 min. A third session consisted of 60 min of anodal tDCS. A second group received cathodal tDCS at 200 microA for 15 and for 30 min, as well as anodal tDCS for 30 min.
Sixty minutes of cathodal tDCS at 100 microA resulted in a TLS increase lasting for >or=2 h. When the intensity was increased to 200 microA, a similar lasting TLS elevation occurred after a stimulation of just 30-min duration. In contrast, anodal tDCS at identical stimulation durations and current strengths had no significant effect on TLS.
The anticonvulsive effect induced by cathodal tDCS depends on stimulation duration and current strength and may be associated with the induction of alterations of cortical excitability that outlast the actual stimulation. The results lead to the reasonable assumption that cathodal tDCS could evolve as a therapeutic tool in drug-refractory partial epilepsy.
弱直流电可引起动物和人类皮质兴奋性的持久改变,这种改变受极性、刺激持续时间和施加的电流强度控制。为评估其抗惊厥潜力,在局灶性癫痫的改良皮质斜坡刺激模型中测试了经颅直流电刺激(tDCS)。
通过单侧头皮电极施加单串上升的双极脉冲,在自由活动的大鼠中确定局部癫痫发作活动阈值(TLS)。tDCS后,每隔15分钟重复测定TLS 120分钟。第一组动物接受两次100微安的阴极tDCS,一次30分钟,一次60分钟。第三次为60分钟的阳极tDCS。第二组接受200微安的阴极tDCS 15分钟和30分钟,以及阳极tDCS 30分钟。
100微安的阴极tDCS持续60分钟导致TLS升高持续≥2小时。当强度增加到200微安时,仅刺激30分钟后就出现了类似的TLS持续升高。相比之下,相同刺激持续时间和电流强度的阳极tDCS对TLS没有显著影响。
阴极tDCS诱导的抗惊厥作用取决于刺激持续时间和电流强度,可能与诱导皮质兴奋性改变有关,这种改变在实际刺激后仍持续存在。结果合理推测阴极tDCS可能发展成为药物难治性部分性癫痫的一种治疗工具。