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

Xiao-Tong Ding, Ming-Yu Hu, Chi Wang, Wei Kang, Jinzhao Huang, Rui-Yu Wang, QiuSong Shen, Hou-Ming Kan

Complementary Therapies in Medicine, 2025

356 participants · 8 citations

Abstract

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 EDs, 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…

How strong is the evidence?

Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 356 participants or records.

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