经颅直流电刺激治疗癫痫及神经精神共病的 系统评价
Transcranial Direct Current Stimulation for Epilepsy and Neuropsychiatric Comorbidities: A Systematic Review
摘要: 目的：系统评价经颅直流电刺激(transcranial Direct Current Stimulation, tDCS)对癫痫发作控制及精神共病(抑郁、焦虑)与认知功能结局的疗效与安全性。方法：检索PubMed、Embase、Web of Science与Cochrane Library自建库至2025年10月31日的人体研究，提取刺激参数与主要/次要结局，并对随机对照试验采用Cochrane随机试验偏倚风险评估工具(Risk of Bias 2.0, RoB 2.0)评价方法学质量。结果：阴极tDCS在药物难治性癫痫(Drug-Resistant Epilepsy, DRE)中可短期降低发作频率并抑制发作间期痫样放电(interictal Epileptiform Discharges, IEDs)，证据主要来自DRE中的局灶性癫痫；严重不良事件罕见；情绪与认知结局证据有限且异质性较大。结论：tDCS可作为药物难治性局灶性癫痫的辅助治疗，但疗效维持、最佳参数与反应预测仍需多中心长期研究验证。
Abstract: Objective: To systematically evaluate the efficacy and safety of transcranial Direct Current Stimulation (tDCS) for seizure control, psychiatric comorbidities (depression and anxiety), and cognitive outcomes in epilepsy. Methods: We searched PubMed, Embase, Web of Science, and the Cochrane Library from inception to October 31, 2025 for human studies. Stimulation parameters and primary/secondary outcomes were extracted. Methodological quality of Randomized Controlled Trials (RCTs) was assessed using the Cochrane Risk of Bias 2.0 (RoB 2.0) tool. Results: In Drug-Resistant Epilepsy (DRE), cathodal tDCS was associated with short-term reductions in seizure frequency and suppression of Interictal Epileptiform Discharges (IEDs); available randomized evidence was derived predominantly from focal epilepsy cohorts within the DRE population. Serious adverse events were rare. Evidence for mood and cognitive outcomes was limited and highly heterogeneous. Conclusion: tDCS may be considered an adjunctive therapy for DRE; at present, supportive evidence mainly comes from focal epilepsy subgroups within the DRE population. The durability of benefit, optimal stimulation parameters, and predictors of response require confirmation in larger, multicenter trials with long-term follow-up.
文章引用：宋凌谊, 李梓萌, 鲁庆雯, 邱宇. 经颅直流电刺激治疗癫痫及神经精神共病的 系统评价 [J]. 临床医学进展, 2026, 16(2): 1543-1555. https://doi.org/10.12677/acm.2026.162544

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