Transcranial direct current stimulation (tDCS) in the management of epilepsy: A systematic review

Sudbrack-Oliveira, Pedro; Barbosa, Marina Zanichelli; Thomé‐Souza, Sigride; Razza, Laís B.; Neto, José Gallucci; Valiengo, Leandro; Brunoni, André R.

doi:10.1016/j.seizure.2021.01.020

Cited by 49 publications

(40 citation statements)

References 58 publications

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“…Several studies to date have investigated the role of tDCS in the treatment of epilepsy. Highly heterogeneous methods have likely contributed to inconclusive results overall [ 86 ]. However, none of those previous trials involved tDCS of the cerebellum, even though preclinical studies of deep brain stimulation have reported that cerebellar stimulation might control epileptogenesis [ 87 ].…”

Section: Discussionmentioning

confidence: 99%

Cerebellar Transcranial Direct Current Stimulation in Children with Autism Spectrum Disorder: A Pilot Study on Efficacy, Feasibility, Safety, and Unexpected Outcomes in Tic Disorder and Epilepsy

D’Urso

Toscano

Sanges

et al. 2021

JCM

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Patients with autism spectrum disorder (ASD) display distinctive neurophysiological characteristics associated with significant cognitive, emotional, and behavioral symptoms. Transcranial direct current stimulation (tDCS) applied to the frontal or temporoparietal lobes has demonstrated potential to reduce the severity of ASD-related symptoms. Recently, the cerebellum has been identified as a brain area involved in ASD pathophysiology. In this open-label pilot study, seven ASD patients aged between 9 and 13 years underwent 20 daily sessions of 20 min cathodal stimulation of the right cerebellar lobe. At the end of the treatment, the Aberrant Behavior Checklist (ABC) scores showed a 25% mean reduction in global severity of symptoms, with a more pronounced reduction in the “social withdrawal and lethargy” (−35%), “hyperactivity and noncompliance” (−26%), and “irritability, agitation, and crying” (−25%) subscales. Minor and no improvement were observed in the “stereotypic behavior” (−18%) and “inappropriate speech” (−0%) subscales, respectively. Improvements were not detected in the two patients who were taking psychotropic drugs during the study. Clinical response showed a symptom-specific time course. Quality of sleep and mood improved earlier than hyperactivity and social withdrawal. The treatment was generally accepted by patients and well tolerated. No serious adverse events were reported. Stimulation also appeared to markedly reduce the severity of tics in a patient with comorbid tic disorder and led to the disappearance of a frontal epileptogenic focus in another patient with a history of seizures. In conclusion, cerebellar tDCS is safe, feasible, and potentially effective in the treatment of ASD symptoms among children. Strategies to improve recruitment and retention are discussed.

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Section: Discussionmentioning

confidence: 99%

Cerebellar Transcranial Direct Current Stimulation in Children with Autism Spectrum Disorder: A Pilot Study on Efficacy, Feasibility, Safety, and Unexpected Outcomes in Tic Disorder and Epilepsy

D’Urso

Toscano

Sanges

et al. 2021

JCM

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“…Studies in children and adults with focal as well as refractory focal epilepsy have shown that a stimulation with cathodal tDCS decreases epileptiform discharges 93–96 . Similarly, several meta‐analysis and systematic reviews found that cathodal tDCS application in epileptic patients with either focal epilepsy or refractory focal epilepsy successfully restrained epileptiform activity and reduced seizure frequency 97–100 …”

Section: Non‐invasive Brain Stimulationmentioning

confidence: 98%

Brain stimulation: a therapeutic approach for the treatment of neurological disorders

et al. 2021

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Brain stimulation has become one of the most acceptable therapeutic approaches in recent years and a powerful tool in the remedy against neurological diseases. Brain stimulation is achieved through the application of electric currents using non‐invasive as well as invasive techniques. Recent technological advancements have evolved into the development of precise devices with capacity to produce well‐controlled and effective brain stimulation. Currently, most used non‐invasive techniques are repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS), whereas the most common invasive technique is deep brain stimulation (DBS). In last decade, application of these brain stimulation techniques has not only exploded but also expanded to wide variety of neurological disorders. Therefore, in the current review, we will provide an overview of the potential of both non‐invasive (rTMS and tDCS) and invasive (DBS) brain stimulation techniques in the treatment of such brain diseases.

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“…Based on the large body of literature showing reduced cortical excitability after cathodal transcranial direct current stimulation (tDCS) ( 19 , 20 ), we delivered tDCS at 2 mA to the occipital lobe using large rubber electrodes (5 cm × 7 cm). The electrodes were placed perpendicularly to the midline, such that the cathode was centered to electrode position Oz and the anode was centered to position Fpz according to the international 10–20 system.…”

Section: Case Presentationmentioning

confidence: 99%

Pathological Delta Oscillations in Hallucinogen Persisting Perception Disorder: A Case Report

et al. 2022

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BackgroundHallucinogen persisting perception disorder (HPPD) is characterized by spontaneous recurrence of visual hallucinations or disturbances after previous consumption of hallucinogens, such as lysergic acid diethylamide (LSD). The underlying physiological mechanisms are unknown and there is no standardized treatment strategy available.Case PresentationA 33-year-old male patient presented with persistent visual distortions (halos around objects, intensified colors, positive after images, and trails following moving objects) that developed after repeated use of hallucinogenic drugs at the age of 18. Symptoms developed gradually and worsened several months later, resulting in various pharmacological and psychosocial treatment attempts that remained unsuccessful, however. At presentation, 32-channel electroencephalography (EEG) showed increased delta activity over the occipital brain regions, reminiscent of occipital intermittent rhythmic delta activity (OIRDA) usually seen in children. Two sessions of cathodal (inhibitory) transcranial direct current stimulation (tDCS) over 30 min attenuated visual hallucinations and occipital delta activity by approximately 60%. The response persisted for over four weeks.ConclusionPathological delta activity over occipital brain regions may play an important role in the development and perpetuation of HPPD and can be attenuated by non-invasive brain stimulation.

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Transcranial direct current stimulation (tDCS) in the management of epilepsy: A systematic review

Cited by 49 publications

References 58 publications

Cerebellar Transcranial Direct Current Stimulation in Children with Autism Spectrum Disorder: A Pilot Study on Efficacy, Feasibility, Safety, and Unexpected Outcomes in Tic Disorder and Epilepsy

Cerebellar Transcranial Direct Current Stimulation in Children with Autism Spectrum Disorder: A Pilot Study on Efficacy, Feasibility, Safety, and Unexpected Outcomes in Tic Disorder and Epilepsy

Brain stimulation: a therapeutic approach for the treatment of neurological disorders

Pathological Delta Oscillations in Hallucinogen Persisting Perception Disorder: A Case Report

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