tDCS治疗癫痫患者的安全性和有效性：系统回顾和荟萃分析

IF 3.3 3区医学 Q1 INTEGRATIVE & COMPLEMENTARY MEDICINE

Complementary therapies in medicine Pub Date : 2025-02-03 DOI:10.1016/j.ctim.2025.103142

Xiao-Tong Ding , Ming-Yu Hu , Chi Wang , Wei-Ye Kang , Jin-Zhao Huang , Rui-Yu Wang , Qiu-Song Shen , Hou-Ming Kan

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引用次数: 0

摘要

背景与目的经颅直流电刺激（transcranial direct current stimulation, tDCS）治疗癫痫已有多年历史，但tDCS治疗的有效性和安全性有待进一步研究。本系统综述和荟萃分析旨在探讨tDCS对癫痫发作频率（SF）、癫痫样放电、抑郁、焦虑和认知功能的影响。材料和方法我们检索了Cochrane Library、PubMed、Embase、Scopus和Web of Science数据库，检索时间从成立到2024年9月9日。主要结局包括SF。次要结局包括癫痫样放电、抑郁、焦虑、认知功能和不良事件。meta分析使用Review Manager 5.4软件进行。结果共纳入12项试验，356名受试者（tDCS组219名，假手术组137名）。在纳入的研究中，有3项是高风险的，2项是值得关注的，7项是低风险的。对于主要结局指标，tDCS可以减少癫痫发作的频率（SMD = - 0.63, 95 % CI = [-0.90, - 0.36], P <； 0.00001）。次要结局指标方面，tDCS组与假手术组在癫痫样放电（SMD = - 0.27, 95 % CI = [-0.71, 0.16], P = 0.22）和不良事件（MD = 1.30, 95 % CI = [0.49, 3.45], P = 0.60）方面无统计学差异。tDCS治疗抑郁和焦虑的结果不一致。tDCS不增强或损害认知功能。结论dcs可降低SF，但对癫痫样放电无影响。目前的证据仅限于支持tDCS治疗癫痫患者的抑郁、焦虑和认知功能。未来的研究应标准化和个性化，确保更高的方法严谨性，并探讨长期影响，以进一步证明研究结果。

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The safety and effectiveness of tDCS for epileptic patients: A systematic review and meta-analysis

Background and purpose

Although transcranial direct current stimulation (tDCS) has been used in the treatment of epilepsy for many years, further research is needed on the efficacy and safety of tDCS treatment. This systematic review and meta-analysis aimed to explore the effectiveness of tDCS on seizure frequency (SF), epileptiform discharges, depression, anxiety, and cognitive function in epilepsy.

Materials and methods

We searched the Cochrane Library, PubMed, Embase, Scopus, and Web of Science databases from inception to 9 September 2024. The primary outcomes included SF. The secondary outcomes included epileptiform discharges, depression, anxiety, cognitive function, and adverse events. The meta-analysis was conducted using Review Manager 5.4 software.

Results

12 trials were included, 356 participants (219 in the tDCS group and 137 in the sham group). Among the included studies, three were of high risk, two were of some concern, and seven were of low risk. For the primary outcome metrics, tDCS can reduce the frequency of epileptic seizures (SMD = − 0.63, 95 % CI = [-0.90, − 0.36], P < 0.00001). For secondary outcome measures, there are no statistical differences between the tDCS group and the sham group in epileptiform discharges (SMD = − 0.27, 95 % CI = [-0.71, 0.16], P = 0.22) and adverse events (MD = 1.30, 95 % CI = [0.49, 3.45], P = 0.60). The outcomes of tDCS treatment for depression and anxiety were inconsistent. tDCS did not enhance or impair cognitive function.

Conclusion

tDCS can reduce SF but has no effect on epileptiform discharges in patients with epilepsy. The current evidence is limited to support tDCS treatment for depression, anxiety, and cognitive function in epilepsy patients. Future studies should be standardized and personalized, ensure higher methodological rigor, and probe long-term effects to prove the findings further.

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来源期刊

Complementary therapies in medicine 医学-全科医学与补充医学

CiteScore

8.60

自引率

2.80%

发文量

101

审稿时长

112 days

期刊介绍： Complementary Therapies in Medicine is an international, peer-reviewed journal that has considerable appeal to anyone who seeks objective and critical information on complementary therapies or who wishes to deepen their understanding of these approaches. It will be of particular interest to healthcare practitioners including family practitioners, complementary therapists, nurses, and physiotherapists; to academics including social scientists and CAM researchers; to healthcare managers; and to patients. Complementary Therapies in Medicine aims to publish valid, relevant and rigorous research and serious discussion articles with the main purpose of improving healthcare.