title: Exploring the efficacy of a 5-day course of transcranial direct current stimulation (TDCS) on depression and memory function in patients with well-controlled temporal lobe epilepsy.
abstract: BACKGROUND
  Depression and memory dysfunction significantly impact the quality of life of patients with epilepsy. Current therapies for these cognitive and psychiatric comorbidities are limited. We explored the efficacy and safety of transcranial direct current stimulation (TDCS) for treating depression and memory dysfunction in patients with temporal lobe epilepsy (TLE).
  
  
  METHODS
  Thirty-seven (37) adults with well-controlled TLE were enrolled in a double-blinded, sham-controlled, randomized, parallel-group study of 5 days of fixed-dose (2 mA, 20 min) TDCS. Subjects were randomized to receive either real or sham TDCS, both delivered over the left dorsolateral prefrontal cortex. Patients received neuropsychological testing and a 20-minute scalp EEG at baseline immediately after the TDCS course and at 2- and 4-week follow-up.
  
  
  RESULTS
  There was improvement in depression scores immediately after real TDCS, but not sham TDCS, as measured by changes in the Beck Depression Inventory (BDI change: -1.68 vs. 1.27, p<0.05) and NDDI-E (-0.83 vs. 0.9091, p=0.05). There was no difference between the groups at the 2- or 4-week follow-up. There was no effect on delayed or working memory performance. Transcranial direct current stimulation was well-tolerated and did not increase seizure frequency or interictal discharge frequency. Transcranial direct current stimulation induced an increase in delta frequency band power over the frontal region and delta, alpha, and theta band power in the occipital region after real stimulation compared to sham stimulation, although the difference did not reach statistical significance.
  
  
  CONCLUSIONS
  This study provides evidence for the use of TDCS as a safe and well-tolerated nonpharmacologic approach to improving depressive symptoms in patients with well-controlled TLE. However, there were no changes in memory function immediately following or persisting after a stimulation course. Further studies may determine optimal stimulation parameters for maximal mood benefit.
authors.affiliation: NYU Comprehensive Epilepsy Center, USA; NYU School of Medicine, USA; Berenson Allen Center for Non-invasive Brain Stimulation, Division of Cognitive Neurology, USA. Electronic address: Anli.liu@nyumc.org.
authors.forename: Anli
authors.initials: A
authors.lastname: Liu
authors.affiliation: NYU Comprehensive Epilepsy Center, USA; NYU Graduate School of Psychology, USA.
authors.forename: Andrew
authors.initials: A
authors.lastname: Bryant
authors.affiliation: NYU Comprehensive Epilepsy Center, USA; NYU Graduate School of Psychology, USA.
authors.forename: Ashlie
authors.initials: A
authors.lastname: Jefferson
authors.affiliation: NYU Comprehensive Epilepsy Center, USA; NYU School of Medicine, USA.
authors.forename: Daniel
authors.initials: D
authors.lastname: Friedman
authors.affiliation: NYU Comprehensive Epilepsy Center, USA; NYU School of Medicine, USA.
authors.forename: Preet
authors.initials: P
authors.lastname: Minhas
authors.affiliation: NYU Comprehensive Epilepsy Center, USA; NYU School of Medicine, USA.
authors.forename: Sarah
authors.initials: S
authors.lastname: Barnard
authors.affiliation: NYU Comprehensive Epilepsy Center, USA; NYU School of Medicine, USA.
authors.forename: William
authors.initials: W
authors.lastname: Barr
authors.affiliation: NYU Comprehensive Epilepsy Center, USA; NYU School of Medicine, USA.
authors.forename: Thomas
authors.initials: T
authors.lastname: Thesen
authors.affiliation: Beth Israel Deaconess Medical Center, USA; Harvard Medical School, USA.
authors.forename: Margaret
authors.initials: M
authors.lastname: O'Connor
authors.affiliation: Beth Israel Deaconess Medical Center, USA; Berenson Allen Center for Non-invasive Brain Stimulation, Division of Cognitive Neurology, USA; Harvard Medical School, USA.
authors.forename: Mouhsin
authors.initials: M
authors.lastname: Shafi
authors.affiliation: Beth Israel Deaconess Medical Center, USA; Harvard Medical School, USA.
authors.forename: Susan
authors.initials: S
authors.lastname: Herman
authors.affiliation: NYU Comprehensive Epilepsy Center, USA; NYU School of Medicine, USA.
authors.forename: Orrin
authors.initials: O
authors.lastname: Devinsky
authors.affiliation: Beth Israel Deaconess Medical Center, USA; Berenson Allen Center for Non-invasive Brain Stimulation, Division of Cognitive Neurology, USA; Harvard Medical School, USA.
authors.forename: Alvaro
authors.initials: A
authors.lastname: Pascual-Leone
authors.affiliation: Beth Israel Deaconess Medical Center, USA; Harvard Medical School, USA.
authors.forename: Steven
authors.initials: S
authors.lastname: Schachter
mesh_terms: D000328:Adult; D003866:Depressive Disorder / Q000209:etiology / Q000523:psychology* / Q000628:therapy*; D004311:Double-Blind Method; D004569:Electroencephalography; D004833:Epilepsy, Temporal Lobe / Q000150:complications / Q000523:psychology* / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008569:Memory Disorders / Q000209:etiology / Q000523:psychology* / Q000628:therapy*; D008570:Memory, Short-Term; D008875:Middle Aged; D009483:Neuropsychological Tests; D017397:Prefrontal Cortex; D011569:Psychiatric Status Rating Scales; D011597:Psychomotor Performance; D011788:Quality of Life; D065908:Transcranial Direct Current Stimulation / Q000009:adverse effects
keywords: Depression; Memory; Neurostimulation; Stimulation safety; Temporal lobe epilepsy; Transcranial direct current stimulation