Transcranial direct current stimulation in refractory continuous spikes and waves during slow sleep: a controlled...

Area of Science:

• Neuroscience
• Neurology
• Epileptology

Background:

• Cortical excitability is modulated by transcranial direct current stimulation (tDCS).
• Cathodal tDCS is known to decrease cortical excitability.
• Continuous epileptiform activity, such as spikes and waves during slow sleep, can be refractory to conventional treatments.

Purpose of the Study:

• To investigate the efficacy of cathodal tDCS in interrupting continuous epileptiform activity.
• To assess the impact of cathodal tDCS on spike-index in patients with focal refractory epilepsy.

Main Methods:

• Five patients with focal, refractory continuous spikes and waves during slow sleep were enrolled.
• Both cathodal tDCS (1 mA; 20 min) and sham stimulation were applied over the epileptic focus before sleep.
• Spike-index was used as the primary outcome measure.

Main Results:

• Cathodal tDCS did not significantly reduce the spike-index in any of the five patients.
• No interruption of continuous epileptiform activity was observed with cathodal tDCS.
• Sham stimulation served as a control for the effects of the procedure.

Conclusions:

• Cathodal tDCS, applied over the epileptic focus, was ineffective in reducing continuous epileptiform activity during slow sleep in this cohort.
• Further research is needed to explore alternative neuromodulation strategies for refractory epilepsy.