TITLE
Transcranial Direct-Current Stimulation as Treatment in Epilepsy

AUTHORS
Gschwind M; Seeck M. Institution Gschwind, Markus. a EEG and Epilepsy Unit, Service of Neurology, Department of Clinical Neurosciences, University Hospital Geneva, Geneva, Switzerland. Gschwind, Markus. b Functional Brain Mapping Laboratory, Department of Neuroscience, Biotech Campus, University of Geneva, Geneva , Switzerland. Seeck, Margitta. a EEG and Epilepsy Unit, Service of Neurology, Department of Clinical Neurosciences, University Hospital Geneva, Geneva, Switzerland.

SOURCE
Expert Review of Neurotherapeutics. 16(12):1427-1441, 2016 Dec.

INTRODUCTION
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.