A controlled clinical trial of cathodal DC polarization in patients with refractory epilepsy.
OBJECTIVE
To study the effects of cathodal DC polarization in patients with refractory epilepsy and malformations of cortical development (MCDs) as indexed by seizure frequency and epileptiform EEG discharges.


METHODS
Nineteen patients with MCDs and refractory epilepsy underwent one session of DC polarization (20 min, 1 mA) targeting the epileptogenic focus. The number of epileptiform discharges (EDs) in the EEG and seizures were measured before (baseline), immediately after, and 15 and 30 days after either sham or active DC polarization. Seizure frequency after the treatment was compared with baseline.


RESULTS
Active compared with sham DC polarization was associated with a significant reduction in the number of epileptiform discharges [mean ED reduction of -64.3% (95% CI, -122.5% to -6.0%) for the active treatment group and -5.8% (95% CI, -26.8% to 15.2%) for the sham treatment group]. A trend (p = 0.06) was noted for decrease in seizure frequency after active compared with sham treatment [mean seizure frequency decrease of -44.0% (95% CI, -95.0% to 7.1%) for the active treatment group and -11.1% (95% CI, -22.2% to 44.4%) for the sham treatment group].


CONCLUSIONS
This randomized, controlled study shows that cathodal DC polarization does not induce seizures and is well tolerated in patients with refractory epilepsy and MCDs. Furthermore, the results suggest that this technique might have an antiepileptic effect based on clinical and electrophysiological criteria.
Fregni
Felipe
F
Harvard Center for Noninvasive Brain Stimulation and Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, KS 452, Boston, MA 02215, U.S.A. ffregni@bidmc.harvard.edu
Thome-Souza
Sigride
S
Nitsche
Michael A
MA
Freedman
Steven D
SD
Valente
Kette D
KD
Pascual-Leone
Alvaro
A
D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use; D002540:Cerebral Cortex / Q000002:abnormalities* / Q000502:physiology* / Q000503:physiopathology; D004351:Drug Resistance; D004599:Electric Stimulation Therapy / Q000009:adverse effects / Q000379:methods*; D004569:Electroencephalography / Q000706:statistics & numerical data; D004827:Epilepsy / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D012640:Seizures / Q000453:epidemiology / Q000209:etiology; D016896:Treatment Outcome
D000927:Anticonvulsants