Effectiveness of Transcranial Direct Current Stimulation on improving the inhibition in childhood drug-resistant temporal lobe Epilepsy

Document Type : Original Article


1 Department of Psychology Faculty of Education and Psychology, Ferdowsi university of mashhhad, Mashhad, Iran

2 Department of Education Faculty of Education and Psychology, ferdowsi university of mashhad, mashhad, iran

3 MD, Pediatric neurologist, Professor of Mashhad University of Medical science, Iran.

4 MD, Pediatric Neurology fellowship, Mashhad University of Medical science, Iran.


Introduction: Epilepsy is a chronic disease characterized by epileptic seizures that are identified by suddenly attacks, usually without eliciting external event, along with disorder of consciousness and involuntary movements. The purpose of the present study was to examine the effect of transcranial direct current stimulation (tDCS) on improving the inhibition of childhood drug-resistant temporal lobe Epilepsy.

Method: The present research use a single subject design. The research population included all clients referred to the clinic of Ghaem Hospital of Mashhad, in 2015 to 2018 and were diagnosed by an expert neurologist with experience on drug-resistant temporal lobe Epilepsy. The age range of subjects were between 6 and 18 years old and 5 patients were selected. The research tools were Porteus Maze Test and the Go-No Go Test. The final results were analyzed using a visual analysis chart and a  recovery percentage formula.

Results: Results were shown that in the Go-No Go Test, for the majority of subjects the commission error decreased. The percentage of recovery for 3 subjects were over 50 percent which is a sign of clinical recovery. The other two subjects revealed a lower recovery in commission error.

Conclusion: This study suggest that tDCS intervention  play a significant role on improving the inhibition of epileptic children. Hence the use of such a new therapies as tDCS that requires no medication will have beneficial effects on patients’ lives and their mental functioning.


Main Subjects

1- Andreoli TE, Carpenter CJ, Griggs RC, Loscalzo J. Andreoli and Carpenter's Cecil Essentials of Medicine: Elsevier PressS. 2004. 459-60.
2- Liao W, Zhang Z, Pan Z, Mantini D, Ding j, Duan X, et al. Altered functional connectivity and small-world in mesial temporal lobe epilepsy. PloS one. 2010; 5(1): 8525.
3- Zhang X, Tokoglu F, Negishi M, Arora J, Winstanley S, Spencer DD, et al. Social network theory applied to resting-state fMRI connectivity data in the identification of epilepsy networks with iterative feature selection. Journal of neuroscience methods. 2011; 199(1): 129-39.
4- Engel J. Update on surgical treatment of the epilepsies Summary of The Second International Palm Desert Conference on the Surgical Treatment of the Epilepsies (1992). Neurology. 1993; 43(8): 1612- 7.
5- Rzezak P, Valente KD, Duchowny MS. Temporal lobe epilepsy in children: executive and mnestic impairments. Epilepsy & Behavior. 2014; 31: 117-22.
6- Lezak MD. Neuropsychological assessment. USA: Oxford University Press. 2004.
7- Stuss DT, Alexander MP. Is there a dysexecutive syndrome? . Philosophical Transactions of the Royal Society B: Biological Sciences. 2007; 362(1481): 901-15.
8- Hermann BP, Seidenberg M, Schoenfeld J, Davies K. Neuropsychological characteristics of the syndrome of mesial temporal lobe epilepsy. Archives of neurology. 1997; 54(4): 369-76.
9- Rzezak P, Fuentes D, Guimarães CA, Thome-Souza S, Kuczynski E, Li LM, et al. Frontal lobe dysfunction in children with temporal lobe epilepsy. Pediatric neurology. 2007; 37(3): 176-85.
10- Hermann BP, Seidenberg M. Executive system dysfunction in temporal lobe epilepsy: effects of nociferous cortex versus hippocampal pathology. Journal of Clinical and Experimental Neuropsychology. 1995; 17(6): 809-19.
11- Brodie M, Barry S, Bamagous G. Patterns of treatment response in newly diagnosed epilepsy. Neurology. 2012; 78(20): 1548-54.
12- Fisher RS, Velasco AL. Electrical brain stimulation for epilepsy. Nature Reviews Neurology. 2014; 10(5): 261-70.
13- McCormick DA, Contreras D. On the cellular and network bases of epileptic seizures. Annual review of physiology. 2001; 63(1): 815-46.
14- Purpura DP, Mc Murtry JG. Intracellular activities and evoked potential changes during polarization of motor cortex. Journal of neurophysiology. 1965; 28(1): 166-85.
15- Fregni F, Thome‐Souza S, Nitsche MA, Freedman SD, Valente KD, Pascual‐Leone A. A controlled clinical trial of cathodal DC polarization in patients with refractory epilepsy. Epilepsia. 2006; 47(2): 335-42.
16- Gschwind M, Seeck M. Transcranial direct-current stimulation as treatment in epilepsy. Expert review of neurotherapeutics. 2016; 16(12): 1427-41.
17- Poreisz C, Boros K, Antal A, Paulus W. Safety aspects of transcranial direct current stimulation concerning healthy subjects and patients. Brain research bulletin. 2007; 72 (4-6): 208-14.
18- Auvichayapat N, Rotenberg A, Gersner R, Ngodklang S, Tiamkao S, Tassaneeyakul W, et al. Transcranial direct current stimulation for treatment of refractory childhood focal epilepsy. Brain Stimulation: Basic, Translational, and Clinical Research in Neuromodulation. 2013; 6(4): 696-700.
19- Del Felice A, Magalini A, Masiero S. Slow-oscillatory transcranial direct current stimulation modulates memory in temporal lobe epilepsy by altering sleep spindle generators: a possible rehabilitation tool. Brain Stimulation: Basic, Translational, and Clinical Research in Neuromodulation. 2015; 8(3): 567-73.
20- Amatachaya A, Auvichayapat N, Patjanasoontorn N, Suphakunpinyo C, Ngernyam N, Aree-uea B, et al. Effect of anodal transcranial direct current stimulation on autism: a randomized double-blind crossover trial. Behavioural Neurology. 2014; 2014 :1-7.
21- Karvigh SA, Motamedi M, Arzani M, Roshan JHN. HD-tDCS in refractory lateral frontal lobe epilepsy patients. Seizure-European Journal of Epilepsy. 2017; 47: 74-80.
22- Berg AT, Shinnar S, Levy S, Testa F, Smith–Rapaport S, Beckerman B. Early development of intractable epilepsy in children A prospective study. Neurology. 2001; 56(11): 1445-52.
23- Palkes H, Stewart M, Kahana B. Porteus maze performance of hyperactive boys after training in self-directed verbal commands. Child Development. 1968; 817-26.
24- Hadianfard H. Making and Standardizing the Lining up Test (Persian Version) for the Elementary Students of Shiraz. JOURNAL OF SOCIAL SCIENCES AND HUMANITIES OF SHIRAZ UNIVERSITY. 2007; 52: 193-209.
25- Ghadiri F, Jazayeri A, Ashayeri H, Qazi Tabatabaei M. The Role of Inhibitation in the Reduction of Deficit Executive Actions and Obsessive Symptoms of Obsessive-Schizophrenic Patients. Archives of Rehabilitation. 2006; 7(4): 11-24.
26- Naseri E, Sohrabi F, Borjali A, Falsafinejad MR. The Effectiveness of Two-Way Schema Therapy in the Treatment of Heroin Dependence with Antisocial Individual Dysfunction. Journal Clinical Psychology. 2015; 18(5): 75-97.
27- Imani M, Rajabi GR, Khojasteh MR, Bairami M, Beshlideh K. The Effectiveness of Acupuncture-Based Treatments and Adopted Paired Commitment, Integrative Behavioral Paternal Therapy on Reducing Signs of Concern and Marital Inconsistency in Women with Marital Disturbances and General Anxiety Disorder. Journal  Counsel and Psychotherapy. 2013; 3(1): 56-88.
28- Nitsche MA, Fricke K, Henschke U, Schlitterlau A, Liebetanz D, Lang N, et al. Pharmacological modulation of cortical excitability shifts induced by transcranial direct current stimulation in humans. The Journal of physiology. 2003; 553(1): 293-301.
29- Minamoto T, Azuma M, Yaoi K, Ashizuka A, Mima T, Osaka M, et al. The anodal tDCS over the left posterior parietal cortex enhances attention toward a focus word in a sentence. Frontiers in human neuroscience. 2014; 8: 992-1000.
30- Boggio PS, Nunes A, Rigonatti SP, Nitsche MA, Pascual-Leone A, Fregni F. Repeated sessions of noninvasive brain DC stimulation is associated with motor function improvement in stroke patients. Restorative neurology and neuroscience. 2007; 25(2): 123-9.
31- Loftus AM, Yalcin O, Baughman FD, Vanman EJ, Hagger MS. The impact of transcranial direct current stimulation on inhibitory control in young adults. Brain and behavior. 2015; 5(5): 00332 (1-9).