Zoghi Maryam, O'Brien Terence J, Kwan Patrick, Cook Mark J, Galea Mary, Jaberzadeh Shapour
Department of Medicine The Royal Melbourne Hospital The University of Melbourne Parkville Victoria Australia.
Department of Medicine St Vincent's Hospital The University of Melbourne Fitzroy Victoria Australia.
Epilepsia Open. 2016 Oct 17;1(3-4):130-135. doi: 10.1002/epi4.12020. eCollection 2016 Dec.
To investigate the effect of cathodal transcranial direct-current stimulation (c-tDCS) on seizure frequency in patients with drug-resistant temporal lobe epilepsy (TLE).
Twenty-nine patients with drug-resistant TLE participated in this study. They were randomized to experimental or sham group. Twenty participants (experimental group) received within-session repeated c-tDCS intervention over the affected temporal lobe, and nine (sham group) received sham tDCS. Paired-pulse transcranial magnetic stimulation was used to assess short interval intracortical inhibition (SICI) in primary motor cortex ipsilateral to the affected temporal lobe. SICI was measured from motor evoked potentials recorded from the contralateral first dorsal interosseous muscle. Adverse effects were monitored during and after each intervention in both groups. A seizure diary was given to each participant to complete for 4 weeks following the tDCS intervention. The mean response ratio was calculated from their seizure rates before and after the tDCS intervention.
The experimental group showed a significant increase in SICI compared to the sham group (F = 10.3, p = 0.005). None of the participants reported side effects of moderate or severe degree. The mean response ratio in seizure frequency was -42.14% (standard deviation [SD] 35.93) for the experimental group and -16.98% (SD 52.41) for the sham group.
Results from this pilot study suggest that tDCS may be a safe and efficacious nonpharmacologic intervention for patients with drug-resistant TLE. Further evaluation in larger double-blind randomized controlled trials is warranted.
探讨阴极经颅直流电刺激（c-tDCS）对药物难治性颞叶癫痫（TLE）患者癫痫发作频率的影响。
29例药物难治性TLE患者参与本研究。他们被随机分为实验组或假刺激组。20名参与者（实验组）在患侧颞叶接受疗程内重复c-tDCS干预，9名（假刺激组）接受假tDCS。采用配对脉冲经颅磁刺激评估患侧颞叶同侧初级运动皮层的短间隔皮质内抑制（SICI）。SICI通过对侧第一背侧骨间肌记录的运动诱发电位进行测量。两组在每次干预期间及之后均监测不良反应。在tDCS干预后，给每位参与者一份癫痫发作日记，让其记录4周。根据tDCS干预前后的癫痫发作率计算平均反应率。
与假刺激组相比，实验组的SICI显著增加（F = 10.3，p = 0.005）。没有参与者报告中度或重度副作用。实验组癫痫发作频率的平均反应率为-42.14%（标准差[SD] 35.93），假刺激组为-16.98%（SD 52.41）。
这项初步研究的结果表明，tDCS可能是一种对药物难治性TLE患者安全有效的非药物干预措施。有必要在更大规模的双盲随机对照试验中进行进一步评估。
