title: Transcranial direct-current stimulation as treatment in epilepsy.
abstract: Neuromodulation (NM) is a complementary therapy for patients with drug-resistant epilepsy. Vagal nerve stimulation and deep brain stimulation of the anterior thalamus are established techniques and have shown their efficacy in lowering seizure frequency, but they are invasive and rarely render patients seizure-free. Non-invasive NM techniques are therefore increasingly investigated in a clinical context. Areas covered: Current knowledge about transcranial direct-current stimulation (tDCS) and other non-invasive NM in patients with epilepsy, based on the available animal and clinical studies from PubMed search. Expert commentary: tDCS modulates neuronal membrane potentials, and consequently alters cortical excitability. Cathodal stimulation leads to cortical inhibition, which is of particular importance in epilepsy treatment. The antiepileptic efficacy is promising but still lacks systematic studies. The beneficial effect, seen in ~20%, outlasts the duration of stimulation, indicating neuronal plasticity and is therefore of great interest to obtain long-term effects.
authors.affiliation: a EEG and Epilepsy Unit, Service of Neurology, Department of Clinical Neurosciences , University Hospital Geneva , Geneva , Switzerland.|b Functional Brain Mapping Laboratory, Department of Neuroscience, Biotech Campus , University of Geneva , Geneva , Switzerland.
authors.forename: Markus
authors.initials: M
authors.lastname: Gschwind
authors.affiliation: a EEG and Epilepsy Unit, Service of Neurology, Department of Clinical Neurosciences , University Hospital Geneva , Geneva , Switzerland.
authors.forename: Margitta
authors.initials: M
authors.lastname: Seeck
mesh_terms: D000818:Animals; D046690:Deep Brain Stimulation; D004827:Epilepsy / Q000628:therapy*; D006801:Humans; D009473:Neuronal Plasticity; D065908:Transcranial Direct Current Stimulation; D050781:Transcranial Magnetic Stimulation
keywords: DBS; Epilepsy; TMS; VNS; adults; children vagal nerve stimulation; deep brain stimulation; drug therapy; outcome; tDCS; transcranial direct-current stimulation; transcranial magnetic stimulation