Efficacy of transcranial direct current stimulation on seizure control in patients with refractory epilepsy: a systematic review and meta-analysis of randomized controlled trials

PMCID: PMC12177013

PMID: 40533536

DOI: 10.1007/s10143-025-03657-0

Journal: Neurosurgical review

Publication Date: 2025-6-19

Authors: Hendi NI, AbuSammour Y, Khaled M, Mohamed AS, Amin AM, et al.

Key Points

• tDCS demonstrated a statistically significant reduction in seizure frequency across multiple follow-up periods
• Seizure frequency reduction reached up to 71% in some study subgroups, with minimal side effects
• Non-invasive tDCS offers a potential therapeutic option for patients with drug-resistant epilepsy, warranting further large-scale research

Summary

This meta-analysis comprehensively evaluated the effectiveness of transcranial direct current stimulation (tDCS) in managing drug-resistant epilepsy (DRE), a challenging condition affecting approximately 30% of epilepsy patients. By systematically reviewing 10 randomized controlled trials involving 269 patients, the study demonstrated significant potential for non-invasive seizure management through tDCS.

The research revealed clinically meaningful outcomes, with monthly seizure frequency significantly reduced by 45.39% at 4 weeks and 39.34% at 8 weeks. Notably, interictal epileptiform discharges (IEDs) were substantially decreased across multiple follow-up periods, with standardized mean differences ranging from -0.87 to -1.17. The intervention showed minimal adverse effects, suggesting tDCS as a promising alternative for patients with treatment-resistant epilepsy, particularly when surgical interventions are challenging or contraindicated.