PMID- 27693237 OWN - NLM STAT- MEDLINE DCOM- 20170920 LR - 20181202 IS - 1876-4754 (Electronic) IS - 1876-4754 (Linking) VI - 10 IP - 1 DP - 2017 Jan-Feb TI - Transcranial Direct Current Stimulation in Mesial Temporal Lobe Epilepsy and Hippocampal Sclerosis. PG - 28-35 LID - S1935-861X(16)30247-9 [pii] LID - 10.1016/j.brs.2016.08.013 [doi] AB - BACKGROUND: Transcranial direct current stimulation (tDCS) has been evaluated in medication refractory epilepsy patients. The results have been inconclusive and protocols have varied between studies. OBJECTIVE: To evaluate the safety and efficacy of two protocols of tDCS in adult patients with mesial temporal lobe epilepsy and hippocampal sclerosis (MTLE-HS). METHODS: This is a randomized placebo-controlled, double-blinded clinical trial, with 3 arms, 3 sessions, 5 sessions and placebo stimulation. Frequency of seizures (SZs), interictal epileptiform discharges (IEDs) and adverse effects (AEs) were registered before and after treatment, and at 30 and 60 days follow-up. Descriptive statistics, k-related samples, Friedman's test, and relative risk (RR) estimation were used for analysis. RESULTS: We included twenty-eight subjects (3d n = 12, 5d n = 8, placebo n = 8), 16/28 (57%) men, age 37.8(+/-10.9) years old. There was a significant reduction of the frequency of SZs at one (p = 0.001) and two (p = 0.0001) months following cathodal tDCS compared to baseline in the 3 arms (p = 0.0001). The mean reduction of SZ frequency at two months in both active groups was significantly higher than placebo (-48% vs. -6.25%, p < 0.008). At 3 days (-43.4% vs. -6.25%, p < 0.007) and 5 days (-54.6% vs. -6.25%, p < 0.010) individual groups showed a greater reduction of SZs. A significant IED reduction effect was found between baseline and immediately after interventions (p = 0.041) in all groups. Side effects were minor. CONCLUSIONS: Cathodal tDCS technique of 3 and 5 sessions decreased the frequency of SZs and IEDs (between baseline and immediately post-tDCS) in adult patients with MTLE-HS compared to placebo tDCS. CI - Copyright (c) 2016 Elsevier Inc. All rights reserved. FAU - San-Juan, Daniel AU - San-Juan D AD - Clinical Neurophysiology Department, National Institute of Neurology and Neurosurgery Manuel Velasco Suarez, Av. Insurgentes Sur 3877, Col. La Fama, Tlalpan, Ciudad de Mexico 14269, Mexico; Dresden International University, Division of Health Care Sciences, Center for Clinical Research and Management Education, Freiberger Strasse 37, 01067 Dresden, Germany. Electronic address: pegaso31@yahoo.com. FAU - Espinoza Lopez, Dulce Anabel AU - Espinoza Lopez DA AD - Clinical Neurophysiology Department, National Institute of Neurology and Neurosurgery Manuel Velasco Suarez, Av. Insurgentes Sur 3877, Col. La Fama, Tlalpan, Ciudad de Mexico 14269, Mexico. FAU - Vazquez Gregorio, Rafael AU - Vazquez Gregorio R AD - Clinical Neurophysiology Department, National Institute of Neurology and Neurosurgery Manuel Velasco Suarez, Av. Insurgentes Sur 3877, Col. La Fama, Tlalpan, Ciudad de Mexico 14269, Mexico. FAU - Trenado, Carlos AU - Trenado C AD - Institute of Clinical Neuroscience and Medical Psychology, University Hospital Dusseldorf, Moorenstrasse 5, 40225 Dusseldorf, Germany. FAU - Fernandez-Gonzalez Aragon, Maricarmen AU - Fernandez-Gonzalez Aragon M AD - Clinical Neurophysiology Department, National Institute of Neurology and Neurosurgery Manuel Velasco Suarez, Av. Insurgentes Sur 3877, Col. La Fama, Tlalpan, Ciudad de Mexico 14269, Mexico. FAU - Morales-Quezada, Leon AU - Morales-Quezada L AD - Laboratory of Neuromodulation, Department of Physical Medicine & Rehabilitation, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, 125 Nashua Street, Boston, MA 02114, USA; Program in Placebo Studies, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Ave, Boston, MA 02215, USA. FAU - Hernandez Ruiz, Axel AU - Hernandez Ruiz A AD - Superior School of Medicine, National Polytechnic Institute, Av. Salvador Diaz Miron esq. Plan de San Luis, Col. Casco de Santo Tomas, Miguel Hidalgo, Ciudad de Mexico 11340, Mexico. FAU - Hernandez-Gonzalez, Flavio AU - Hernandez-Gonzalez F AD - Superior School of Medicine of Autonomous University of Aguascalientes, Av. Universidad 940, Ciudad Universitaria, Aguascalientes, Aguascalientes 20131, Mexico. FAU - Alcaraz-Guzman, Alejandro AU - Alcaraz-Guzman A AD - Superior School of Medicine of University of Colima, Av. Universidad 333, Las viboras, Colima, Colima 28040, Mexico. FAU - Anschel, David J AU - Anschel DJ AD - Comprehensive Epilepsy Center of Long Island, St. Charles Hospital, Port Jefferson, NY, USA. FAU - Fregni, Felipe AU - Fregni F AD - Laboratory of Neuromodulation, Department of Physical Medicine & Rehabilitation, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, 125 Nashua Street, Boston, MA 02114, USA. LA - eng SI - ClinicalTrials.gov/NCT01763294 PT - Journal Article PT - Randomized Controlled Trial DEP - 20160831 PL - United States TA - Brain Stimul JT - Brain stimulation JID - 101465726 SB - IM MH - Adult MH - Aged MH - Double-Blind Method MH - Electroencephalography/methods MH - Epilepsy, Temporal Lobe/pathology/*physiopathology/*therapy MH - Female MH - Follow-Up Studies MH - Hippocampus/pathology/*physiopathology MH - Humans MH - Male MH - Middle Aged MH - Sclerosis/pathology/physiopathology/therapy MH - Transcranial Direct Current Stimulation/*methods OTO - NOTNLM OT - Hippocampal sclerosis (HS) OT - Mesial temporal lobe epilepsy (MTLE) OT - Transcranial direct current stimulation (tDCS) EDAT- 2016/10/04 06:00 MHDA- 2017/09/21 06:00 CRDT- 2016/10/04 06:00 PHST- 2016/03/27 00:00 [received] PHST- 2016/08/23 00:00 [revised] PHST- 2016/08/29 00:00 [accepted] PHST- 2016/10/04 06:00 [pubmed] PHST- 2017/09/21 06:00 [medline] PHST- 2016/10/04 06:00 [entrez] AID - S1935-861X(16)30247-9 [pii] AID - 10.1016/j.brs.2016.08.013 [doi] PST - ppublish SO - Brain Stimul. 2017 Jan-Feb;10(1):28-35. doi: 10.1016/j.brs.2016.08.013. Epub 2016 Aug 31.