Bifrontal transcranial direct current stimulation modulates fatigue in multiple sclerosis: a randomized sham-controlled study

Chalah, Moussa A.; Grigorescu, Christina; Padberg, Frank; Kümpfel, Tania; Palm, Ulrich; Ayache, Samar S.

doi:10.1007/s00702-020-02166-2

Cited by 25 publications

(56 citation statements)

References 48 publications

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“…These protocols were tested in more than 3000 subjects worldwide with no serious adverse events (SAEs), except for some adverse events (AEs) consisting of slight itching under the electrode, mild redness attributed to neutrally driven vasodilation and seldom-occurring headache, fatigue, and/or nausea [32,35]. tDCS was studied in the context of MS, and its efficacy and safety were reported in the context of neuropathic pain [67,68], tactile sensory deficit [69], and fatigue [40,51,[70][71][72][73][74][75], to cite a few. Based on the above, we believe that this study design (5 consecutive daily sessions, 20 min per session, and current intensity of 2 mA, with the proposed circuit setup) is safe and harmless.…”

Section: Safety and Adverse Event Reportingmentioning

confidence: 99%

Effects of Transcranial Direct Current Stimulation on Hand Dexterity in Multiple Sclerosis: A Design for a Randomized Controlled Trial

et al. 2020

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Background: Cerebellar and motor tracts are frequently impaired in multiple sclerosis (MS). Altered hand dexterity constitutes a challenge in clinical practice, since medical treatment shows very limited benefits in this domain. Cerebellar control is made via several cerebellocortical pathways, of which the most studied one links the cerebellum to the contralateral motor cortex via the contralateral ventro-intermediate nucleus of the thalamus influencing the corticospinal outputs. Modulating the activity of the cerebellum or of the motor cortex could be of help. Method: The main interest here is to evaluate the efficacy of transcranial direct current stimulation (tDCS), a noninvasive brain stimulation technique, in treating altered dexterity in MS. Forty-eight patients will be recruited in a randomized, double-blind, sham-controlled, and crossover study. They will randomly undergo one of the three interventions: anodal tDCS over the primary motor area, cathodal tDCS over the cerebellum, or sham. Each block consists of five consecutive daily sessions with direct current (2 mA), lasting 20 min each. The primary outcome will be the improvement in manual dexterity according to the change in the time required to complete the nine-hole pegboard task. Secondary outcomes will include fatigue, pain, spasticity, and mood. Patients’ safety and satisfaction will be rated. Discussion: Due to its cost-effective, safe, and easy-to-use profile, motor or cerebellar tDCS may constitute a potential tool that might improve dexterity in MS patients and therefore ameliorate their quality of life.

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Section: Safety and Adverse Event Reportingmentioning

confidence: 99%

Effects of Transcranial Direct Current Stimulation on Hand Dexterity in Multiple Sclerosis: A Design for a Randomized Controlled Trial

et al. 2020

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“…tDCS was well-tolerated and there were no serious adverse effects at any time. tDCS safety and patients' clinical discomfort did not significantly differ according to the stimulation condition ( 30 ).…”

Section: Resultsmentioning

confidence: 97%

“…Right-handed patients (age: 18–75 years), with a definite MS diagnosis [according to 2017 revised McDonald criteria; ( 35 )] and low disability [Expanded Disability Status Scale score (EDSS) <6.5; ( 36 )] took part of the study. They had stable treatments (≥ 1 month) and did not suffer from relapses (During the last 2 months), or other relevant neuropsychiatric diseases [inclusion/exclusion criteria details are reported in Chalah et al ( 30 )]. The local ethics committee approved the study which was conducted in conformity with the declaration of Helsinki.…”

Section: Methodsmentioning

confidence: 99%

“…The present report is part of a randomized double-blind sham-controlled cross-over study designed to assess the effects of anodal bifrontal tDCS on MS fatigue as well as other components of the symptoms cluster (i.e., anxiety and depression) (30). Five consecutive daily tDCS sessions led to acute antifatigue effects and delayed anxiolytic effects that emerged 1 week later (30).…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, following the same logic, we hypothesized that enhancing the activity of frontal regions and their connectivity, by applying tDCS, could improve general and social cognitive performance in this clinical population. (30)]. The local ethics committee approved the study which was conducted in conformity with the declaration of Helsinki.…”

Section: Introductionmentioning

confidence: 99%

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Effects of Transcranial Direct Current Stimulation on Information Processing Speed, Working Memory, Attention, and Social Cognition in Multiple Sclerosis

et al. 2020

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Transcranial direct current stimulation for fatigue in neurological conditions: A systematic scoping review

Jagadish,

Shankaranarayana,

Natarajan

et al. 2023

Physiotherapy Res Intl

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Background and PurposeFatigue following neurological conditions negatively impacts daily activities, reducing overall quality of life. Transcranial direct current stimulation (tDCS) for fatigue management is still underexplored. This scoping review explores its use in managing fatigue among various neurological conditions.MethodsA thorough literature search was carried out using PubMed, Scopus, CINAHL, Web of Science, Embase, ProQuest, and the Cochrane Library. Google Scholar and clinicaltrials.gov were manually searched for gray literature and ongoing trials, respectively. Regardless of the study design, all studies utilizing tDCS for the management of fatigue in various neurological conditions were considered. Two reviewers independently screened all the studies, following which the data were retrieved.ResultsStudies employing tDCS for fatigue management across neurological conditions is as follows: Multiple sclerosis (MS) (n = 28, 66%), stroke (n = 5, 12%), Parkinson's disease (PD) (n = 4, 10%), post‐polio syndrome (PPS) (n = 2, 5%), traumatic brain injury (TBI) (n = 2, 5%), and amyotrophic lateral sclerosis (n = 1, 2%). All the studies used anodal stimulation, with the common stimulation site being the left dorsolateral prefrontal cortex for MS, stroke, and PD. A stimulation intensity of 1.0–4.0 mA with a duration ranging from 15 to 30 min in 1 to 24 sessions were commonly reported. The Fatigue Severity Scale (n = 21) and Modified Fatigue Impact Scale (n = 17) were frequently implemented outcome measures. Regardless of the study design, 36/42 (85.7%) studies reported an improvement in fatigue scores in the tDCS group. The common adverse events noted were tingling (n = 8, 35%), headache (n = 6, 26%), and itching (n = 6, 26%).DiscussionApplication of tDCS for fatigue was explored in individuals with stroke, PD, PPS, and TBI after MS. Even though a wide range of treatment parameters and outcome measures were adopted to assess and target fatigue, tDCS proves to have a promising role in alleviating this symptom.

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Bifrontal transcranial direct current stimulation modulates fatigue in multiple sclerosis: a randomized sham-controlled study

Cited by 25 publications

References 48 publications

Effects of Transcranial Direct Current Stimulation on Hand Dexterity in Multiple Sclerosis: A Design for a Randomized Controlled Trial

Effects of Transcranial Direct Current Stimulation on Hand Dexterity in Multiple Sclerosis: A Design for a Randomized Controlled Trial

Effects of Transcranial Direct Current Stimulation on Information Processing Speed, Working Memory, Attention, and Social Cognition in Multiple Sclerosis

Transcranial direct current stimulation for fatigue in neurological conditions: A systematic scoping review

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