Quantifying Fatigue Using Electrophysiological Techniques and Non-invasive Brain Stimulation in People With Multiple Sclerosis- A Review and Discussion

Abstract

Objective: The purpose of this literature review article is to provide a synthesis of recent research focused on the use of 3 techniques to evaluate MS-related fatigue: electroencephalography [EEG], transcranial direct-current stimulation (tDSC), and transcranial- magnetic stimulation (TMS). Method: We performed a literature search in the Cumulative Index to Nursing and Allied Health Literature (CINAHL, EBSCOhost), MEDLINE (OVID), APA PsycInfo (OVID), Scopus (Elsevier), and Web of Science (Clarivate) databases, limited to 2015 and after. Results: Our review revealed that fatigue in MS patients can be quantified and predicted using electrophysiological techniques. Such techniques, which yield objective data, are historically assessed in relation to subjective data, or perceived fatigue. We identified studies using EEG, TMS, and/or tDCS to study fatigue in people with MS. In total, 220 records were identified with 19 studies meeting inclusion criteria. Quality appraisal revealed that the level of evidence was generally graded “good”. Conclusions: Despite the heterogenous nature of reviewed the studies and selected the varied self-report fatigue measures, our literature synthesis suggests promise for the use of EEG, TMS, and/or tDCS approaches in more accurately assessing fatigue in people with MS. Further research is needed in this arena.

Transcranial Direct Current Stimulation of Primary Motor Cortex over Multiple Days Improves Motor Learning of a Complex Overhand Throwing Task

“…In addition, numerous studies have found that tDCS is efficacious for motor recovery after stroke [68], especially when combined with other rehabilitation methods [69]. Finally, the preponderance of studies conducted in MS has shown significant effects due to tDCS, with the strongest findings being observed in measurements involving cognitive and physical fatigue [70,71]. In summary, the vast majority of tDCS motor skill and learning studies in every population have involved simple motor tasks, and the findings of the current study suggest that tDCS has the potential to also improve motor learning in complex tasks in populations other than healthy young adults, although perhaps to the same extent as in simple motor tasks.…”