Cathodal HD-tDCS and attention: A study on patients with intractable left lateral frontal lobe epilepsy

Epilepsy Res. 2024 Jan:199:107265. doi: 10.1016/j.eplepsyres.2023.107265. Epub 2023 Nov 28.

Abstract

Objective: Defects in the attentional network in patients with epilepsy are influenced by factors such as the location of epileptic foci. Examining the impact of cathodal high-definition transcranial direct current stimulation (HD-tDCS) on attention components could provide insights into potential attention-related side effects of tDCS. This study aimed to investigate the effect of cathodal HD-tDCS on interictal epileptiform discharges (IEDs), auditory/visual (A/V) attention components, and reaction time (RT) in patients with intractable focal left lateral frontal lobe epilepsy (LFLE).

Methods: To control for variations in individual epilepsy syndrome, 12 adult participants diagnosed with drug-resistant left LFLE with focal cortical IEDs on C3 underwent repeated measurements at pretest, posttest, and follow-up steps. 4 × 1 ring electrodes (cathode on C3 and four anodes on F3, P3, T3, and Cz) delivered 2 mA DC for 20 min per session for 10 consecutive days. The integrated visual and auditory continuous performance test (IVA+) assessed the A/V attention components and RT. One-way repeated-measure ANOVA was used.

Results: The findings suggest a significant effect in reducing IEDs. The IVA+ results showed a significant improvement in auditory divided attention and visual selective and focused attention (p < 0.05). In the follow-up, these changes demonstrated lasting efficacy. A/V speed scales increased (p < 0.05), showing a significant decrease in reaction time.

Conclusions: Cathodal HD-tDCS significantly reduced IEDs and improved the components of auditory divided attention, visual focused attention, and visual selective attention, with a reduction in patient reaction time. A significant lasting, side-effect-free positive effect was observed for up to one month after the intervention.

Keywords: Attention component; Auditory/visual attention; Focal seizures; Lateral frontal lobe epilepsy; Reaction time; TDCS.

MeSH terms

  • Adult
  • Attention / physiology
  • Drug Resistant Epilepsy* / therapy
  • Electrodes
  • Epilepsies, Partial*
  • Epilepsy, Frontal Lobe* / therapy
  • Frontal Lobe
  • Humans
  • Transcranial Direct Current Stimulation* / methods