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 s...

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Main Authors: Xiao-Tong Ding, Ming-Yu Hu, Chi Wang, Wei-Ye Kang, Jin-Zhao Huang, Rui-Yu Wang, Qiu-Song Shen, Hou-Ming Kan
Format: Article
Language:English
Published: Elsevier 2025-05-01
Series:Complementary Therapies in Medicine
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Online Access:http://www.sciencedirect.com/science/article/pii/S0965229925000172
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author Xiao-Tong Ding
Ming-Yu Hu
Chi Wang
Wei-Ye Kang
Jin-Zhao Huang
Rui-Yu Wang
Qiu-Song Shen
Hou-Ming Kan
author_facet Xiao-Tong Ding
Ming-Yu Hu
Chi Wang
Wei-Ye Kang
Jin-Zhao Huang
Rui-Yu Wang
Qiu-Song Shen
Hou-Ming Kan
author_sort Xiao-Tong Ding
collection DOAJ
description 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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series Complementary Therapies in Medicine
spelling doaj-art-2a8e0bc97cde4f83b07945b32998d4fa2025-02-06T05:11:04ZengElsevierComplementary Therapies in Medicine0965-22992025-05-0189103142The safety and effectiveness of tDCS for epileptic patients: A systematic review and meta-analysisXiao-Tong Ding0Ming-Yu Hu1Chi Wang2Wei-Ye Kang3Jin-Zhao Huang4Rui-Yu Wang5Qiu-Song Shen6Hou-Ming Kan7Kiang Wu Nursing College of Macau, Macau SAR, ChinaJiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Jiangsu, ChinaJiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Jiangsu, ChinaJiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Jiangsu, ChinaJiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Jiangsu, ChinaFaculty of Medicine, Macau University of Science and Technology, Macau SAR, ChinaKiang Wu Nursing College of Macau, Macau SAR, ChinaSchool of Pharmacy, Faculty of Medicine, Macau University of Science and Technology, Macau SAR, China; Correspondence to: School of Pharmacy, Faculty of Medicine, Macau University of Science and Technology, Avenida Wai Long, Taipa, Macau SAR, China.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.http://www.sciencedirect.com/science/article/pii/S0965229925000172Transcranial direct current stimulationEpilepsyDepressionAnxietyCognitive functionSystematic review
spellingShingle Xiao-Tong Ding
Ming-Yu Hu
Chi Wang
Wei-Ye Kang
Jin-Zhao Huang
Rui-Yu Wang
Qiu-Song Shen
Hou-Ming Kan
The safety and effectiveness of tDCS for epileptic patients: A systematic review and meta-analysis
Complementary Therapies in Medicine
Transcranial direct current stimulation
Epilepsy
Depression
Anxiety
Cognitive function
Systematic review
title The safety and effectiveness of tDCS for epileptic patients: A systematic review and meta-analysis
title_full The safety and effectiveness of tDCS for epileptic patients: A systematic review and meta-analysis
title_fullStr The safety and effectiveness of tDCS for epileptic patients: A systematic review and meta-analysis
title_full_unstemmed The safety and effectiveness of tDCS for epileptic patients: A systematic review and meta-analysis
title_short The safety and effectiveness of tDCS for epileptic patients: A systematic review and meta-analysis
title_sort safety and effectiveness of tdcs for epileptic patients a systematic review and meta analysis
topic Transcranial direct current stimulation
Epilepsy
Depression
Anxiety
Cognitive function
Systematic review
url http://www.sciencedirect.com/science/article/pii/S0965229925000172
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