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Background Transcranial direct current stimulation (tDCS) has been explored in epilepsy with limited samples, varied parameters, and inconclusive results. We aimed to study the efficacy of tDCS for patients with refractory focal epilepsy. Method We conducted a randomized, double-blind, sham-controlled, and three-arm (Group 1 (sham), Group 2 (20-min), and Group 3 (2 × 20-min)) tDCS parallel multicenter study. The primary outcome measurement was seizure frequencies (SFs). The study consisted of 28-days baseline, 14-days treatment, and 56-days follow-up. The cathode was placed over the epileptogenic focus, and the current intensity was 2 mA. The generalized estimating equations model, one-way analysis of variance, chi-square and Kruskal-Wallis test were used for analysis. Results Of the 82 enrolled patients, 70 patients were included for final analysis (Group 1, n = 21; Group 2, n = 24; and Group 3, n = 25). There was a significant reduction in SFs for both active tDCS groups compared with the sham group. Patients in Group 2 showed a significantly 50.73–21.91% greater reduction in SFs that lasted for 4 weeks (p = 0.008–0.060). Patients in Group 3 showed a significantly 63.19–49.79% greater reduction in SFs compared with the sham group that lasted for 5 weeks (p = 0.011–0.045). Patients in Group 3 had a 64.98–66.32% greater reduction in SFs at W9–W10, when compared with Group 2 (p = 0.021–0.022). Conclusion Fourteen consecutive days tDCS significantly decreased SFs in patients with refractory focal epilepsy, with 2 × 20-min daily stimulation protocol being superior to 20-min daily stimulation protocol.

Objectives Non-invasive brain stimulation (NIBS) is beneficial to many neurological and psychiatric disorders by modulating neuroplasticity and cortical excitability. However, recent studies evidence that single type of NIBS such as transcranial direct current stimulation (tDCS) does not have meaningful clinical therapeutic responses due to their small effect size. Transcranial near-infrared stimulation (tNIRS) is a novel form of NIBS. Both tNIRS and tDCS implement its therapeutic effects by modulating cortical excitability but with different mechanisms. We hypothesized that simultaneous tNIRS and tDCS is superior to single stimulation, leading to a greater cortical excitability. Methods Sixteen healthy subjects participated in a double-blind, sham-controlled, cross-over designed study. Motor evoked potentials (MEPs) were used to measure motor cortex excitability. The changes of MEP were calculated and compared in the sham condition, tDCS stimulation condition, tNIRS condition and the simultaneous tNIRS and anodal tDCS condition. Results tDCS alone and tNIRS alone both elicited higher MEP after stimulation, while the MEP amplitude in the simultaneous tNIRS and tDCS condition was significantly higher than either tNIRS alone or tDCS alone. The enhancement lasted up to at least 30 minutes after stimulation, indicating simultaneous 820 nm tNIRS with 2 mA anodal tDCS have a synergistic effect on cortical plasticity. Conclusions Simultaneous application of tNIRS with tDCS produces a stronger cortical excitability effect. Significance The simultaneous tNIRS and tDCS is a promising technology with exciting potential as a means of treatment, neuro-enhancement, or neuro-protection.

Objective Transcranial near-infrared stimulation (tNIRS) can penetrate the scalp and skull and can reach the superficial layers of the cerebral cortex. In this study, we evaluated whether an 820-nm tNIRS can modulate the excitability of the primary motor cortex (M1) as measured by transcranial magnetic stimulation (TMS). Methods tNIRS was applied at a wavelength of 820-nm for 4 min over the representation of the right first dorsal interosseous muscle (FDI) in the left M1, in 12 healthy right-handed participants. Motor evoked potentials (MEPs) from the FDI elicited by single-pulse TMS were measured at baseline and up to 30 min after the tNIRS. Results The ΔMEPs percentage was evaluated, and a significant increase in amplitude was observed 10−20 min post-stimulation compared to that in sham. Conclusion This study provides evidence that an 820-nm tNIRS induces transitory increase in the excitability of the stimulated cortex.

The purpose of this methodological study was to translate the Breastfeeding Self-Efficacy Scale (BSES) into Mandarin and determine the psychometric characteristics among a sample of 186 Chinese women. The BSES was translated and pilot-tested with 21 breastfeeding women. Following minor revisions to ensure content and semantic equivalence, the instrument was administered to 186 hospitalized breastfeeding women, who were then contacted again at 4 and 8 weeks postpartum to determine their infant feeding method and readminister the Edinburgh Postnatal Depression Scale. The psychometric assessment method used to validate the original BSES (English version) was replicated with the translated Chinese version. The Cronbach's alpha coefficient for the Chinese version BSES was 0.93, suggesting good reliability. Consistent with the English version, the factor analysis procedures resulted in the theorized two-factor solution and as hypothesized, the BSES was significantly correlated with the Edinburgh Postnatal Depression Scale, a theoretically related construct. Support for predictive validity was demonstrated through significant mean differences in BSES scores between breastfeeding and bottle-feeding mothers at 4 and 8 weeks postpartum. The results from this study are the first to examine the psychometric characteristics of the Chinese version BSES administered in a hospital postnatally and provide further evidence of the reliability and validity of the instrument.