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Local and network changes after multichannel transcranial direct current stimulation using magnetoencephalography in patients with refractory epilepsy
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International audience. Objective: Non-invasive neuromodulation techniques, particularly transcranial direct current stimulation (tDCS), are promising for drug-resistant epilepsy (DRE), though the mechanisms of their efficacy remain unclear. This study aims to (i) investigate tDCS neurophysiological mechanisms using a personalized multichannel protocol with magnetoencephalography (MEG) and (ii) assess post-tDCS changes in brain connectivity, correlating them with clinical outcomes.Methods: Seventeen patients with focal DRE underwent three cycles of tDCS over five days, each consisting of 40-minute stimulations targeting the epileptogenic zone (EZ) identified via stereo-EEG. MEG was performed before and after sessions to assess functional connectivity (FC) and power spectral density (PSD),estimated at source level (beamforming).Results: Five of fourteen patients experienced a seizure frequency reduction > 50 %. Distinct PSD changes were seen across frequency bands, with reduced FC in responders and increased connectivity in non-responders (p < 0.05). No significant differences were observed between EZ network and non-involved networks. Responders also had higher baseline FC, suggesting it could predict clinical response to tDCS in DRE.Conclusions: Personalized multichannel tDCS induces neurophysiological changes associated with seizure reduction in DRE.Significance: These results provide valuable insights into tDCS effects on epileptic brain networks, informing future clinical applications in epilepsy treatment.
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