Safety of slow-pulsed transcranial electrical stimulation in acute spike suppression

We examined the effects of slow-pulsed transcranial electrical stimulation (TES) in suppressing epileptiform discharges in seven adults with refractory epilepsy. An MRI-based realistic head model was constructed for each subject and co-registered with 256-channel dense EEG (dEEG). Interictal spikes were localized, and TES targeted the cortical source of each subject's principal spike population. Targeted spikes were suppressed in five subject's (29/35 treatment days overall), and nontargeted spikes were suppressed in four subjects. Epileptiform activity did not worsen. This study suggests that this protocol, designed to induce long-term depression (LTD), is safe and effective in acute suppression of interictal epileptiform discharges.