MS-Related Fatigue Reduced With Transcranial Direct Current Stimulation

tDCS is a promising option for fatigue reduction in multiple sclerosis
tDCS is a promising option for fatigue reduction in multiple sclerosis

Significant reductions in fatigue associated with multiple sclerosis (MS) were seen in patients who underwent a type of electrical brain stimulation called transcranial direct current stimulation (tDCS), according to a study published in the Multiple Sclerosis Journal.

Researchers from the Multiple Sclerosis Comprehensive Care Center at NYU Langone Health sought to evaluate whether tDCS could decrease fatigue in patients with MS, a common and often debilitating feature of MS. The team developed a telerehabilitation protocol that provided tDCS to patients at home through special equipment and real-time supervision; tDCS involves a low-amplitude, direct electrical current that is applied through the electrodes placed on the patient's scalp, targeting the dorsolateral prefrontal cortex. 

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Fatigue was assessed using the Patient-Reported Outcomes Measurement Information System (PROMIS)—Fatigue Short Form. Patients were randomized to receive either tDCS (n=15) or placebo (n=12) while they played a cognitive training game that focused on processing speed and working memory. 

The data showed a statistically significant reduction in the PROMIS scale score with tDCS treatment vs. placebo after 20 sessions. Study patients in the tDCS group demonstrated a mean 5.6-point reduction in fatigue compared to a 0.9-point increase with placebo. The treatment effect also appeared to be greater with more treatments as the data showed greater fatigue reduction after 20 sessions vs. 10 sessions in an initial study. Patients with higher levels of fatigue undergoing tDCS showed the greatest benefit. Moreover, many of the patients were able to achieve near normal levels of fatigue. 

Lauren Krupp, MD, senior study author, stated, "The positive results from our study suggest that tDCS might offer benefit in fatigue reduction. The next step is to see if these benefits can be replicated and sustained in larger studies. But our initial findings are very promising."

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