Testing the effectiveness of transcranial direct stimulation for the treatment of fatigue in multiple sclerosis.
Mult. Scler. J. 2017 Sep 22. doi: https://doi.org/10.1177/1352458517732842. Download PDF: Remotely…sham-controlled trial.
Leigh E Charvet, Bryan Dobbs, Michael T Shaw, Marom Bikson, Abhishek Datta and Lauren B Krupp.
Background: Fatigue is a common and debilitating feature of multiple sclerosis (MS) that remains without reliably effective treatment. Transcranial direct current stimulation (tDCS) is a promising option for fatigue reduction. We developed a telerehabilitation protocol that delivers tDCS to participants at home using specially designed equipment and real-time supervision (remotely supervised transcranial direct current stimulation (RS-tDCS)).
Objective: To evaluate whether tDCS can reduce fatigue in individuals with MS.
Methods: Dorsolateral prefrontal cortex left anodal tDCS was administered using a RS-tDCS protocol, paired with 20minutes of cognitive training. Here, two studies are considered. Study 1 delivered 10 openlabel tDCS treatments (1.5mA; n=15) compared to a cognitive training only condition (n=20). Study 2 was a randomized trial of active (2.0mA, n=15) or sham (n=12) delivered for 20 sessions. Fatigue was assessed using the Patient-Reported Outcomes Measurement Information System (PROMIS)—Fatigue Short Form.
Results and conclusion: In Study 1, there was modest fatigue reduction in the active group (−2.5±7.4 vs −0.2±5.3, p=0.30, Cohen’s d=−0.35). However, in Study 2 there was statistically significant reduction for the active group (−5.6±8.9 vs 0.9±1.9, p=0.02, Cohen’s d=−0.71). tDCS is a potential treatment for MS-related fatigue.