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SYSTEMATIC REVIEW article

Front. Neurol.
Sec. Epilepsy
Volume 15 - 2024 | doi: 10.3389/fneur.2024.1462364

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

Provisionally accepted
Yujie Chen Yujie Chen Zhujing Ou Zhujing Ou Nanya Hao Nanya Hao Hesheng Zhang Hesheng Zhang Enhui Zhang Enhui Zhang Dong Zhou Dong Zhou *Xintong Wu Xintong Wu *
  • Department of Neurology, West China Hospital of Sichuan University, Chengdu, Sichuan, China

The final, formatted version of the article will be published soon.

    Background: Transcranial direct current stimulation (tDCS) has recently become a novel and non-invasive treatment option for refractory epilepsy. Previous systematic reviews have suggested that tDCS may be effective in treating epilepsy, this study presents the first meta-analysis on its effectiveness.We searched PubMed, Embase, Cochrane Library, and Web of Science for relevant randomized controlled trials (RCTs) from database inception to May 2024. The Cochrane risk of bias tool RoB2.0 was used to assess the risk of bias. Primary outcomes included changes in seizure frequency from baseline and the proportion of patients with a ≥50% reduction in seizure frequency.Of the 608 studies initially identified, 14 were finally included. The pooled results from the random-effects model indicated that tDCS significantly reduced seizure frequency (WMD 0.41, 95%CI 0.24, 0.59). Further subgroup analysis revealed that tDCS significantly reduced seizure frequency in temporal lobe epilepsy, and seizure frequency was more alleviated in studies that had treatment sessions of fewer than 5 times, and followed up within 2 months' post-treatment. Only four studies provided data on patients with a ≥50% reduction in seizure frequency, showing no significant difference (RR 2.96, 95%CI 0.85,10.32). In the systematic review, three studies analyzed cognitive function changes after tDCS treatment, but none reported significant improvements. The most common side effect during tDCS treatment was transient tingling, and no patients required additional life-support measures due to side effects.The current meta-analysis on available trials indicates that tDCS can effectively reduce seizure frequency in the short term and is well tolerated. However, its impact on cognitive improvement in epilepsy patients requires further investigation.

    Keywords: Brain Stimulation, transcranial electric stimulation, seizure, Temporal Lobe Epilepsy, nerve stimulation, Brain polarization, randomized controlled trial

    Received: 10 Jul 2024; Accepted: 14 Oct 2024.

    Copyright: © 2024 Chen, Ou, Hao, Zhang, Zhang, Zhou and Wu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Dong Zhou, Department of Neurology, West China Hospital of Sichuan University, Chengdu, 610041, Sichuan, China
    Xintong Wu, Department of Neurology, West China Hospital of Sichuan University, Chengdu, 610041, Sichuan, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.