Neurology Central

Could transcranial direct current stimulation offer relief from fatigue in multiple sclerosis sufferers?

Transcranial direct current stimulation (tDCS) has shown promise as a treatment for fatigue in multiple sclerosis (MS) patients, according to new research from the MS comprehensive care center at NYU Langone health (NY USA).

The controlled study, published in Multiple Sclerosis Journal, included 27 individuals with MS. Participants received either tDCS or a placebo treatment while playing a cognitive training game that targets processing speed and working memory. The non-invasive form of electrical brain stimulation returned statistically significant reductions in comparison with the placebo group, on the 32-point scale of fatigue severity tDCS participants experienced an average 5.6-point drop in fatigue, while the control group saw a 0.9 point increase.

Participants took part in 20-minute sessions, 5 days per week, at their homes. They would videoconference with a member of the study team and receive a unique single-use code to activate their headset. A low-amplitude, direct electrical current was then applied through electrodes placed on the scalp, targeting the brain’s dorsolateral prefrontal cortex. Fifteen patients received tDCS while 12 received the placebo. After 20 sessions, participants reported their level of fatigue using the Patient-Reported Outcomes Measurement Information System.

Author Leigh Charvet (NYU Langone Health) stressed the benefits provided by the flexibility of this technology: “Importantly, tDCS can be delivered remotely to patients at home, offering a practical option for patients, especially those with travel limitations and MS-related disability.”

Around three-quarters of MS sufferers report fatigue amongst their most debilitating symptoms, but despite its prevalence there are no effective treatments available, with the benefits of medications and treatments proving unreliable. tDCS had shown promise in previous studies, including those in MS; however, researchers are encouraged by these findings as they may point to a future role for the technology in fatigue treatment. Researchers were quick to specify that the findings would need to be validated in further, more expansive, studies.

“Fatigue is one of the most common symptoms affecting quality of life for MS patients and practitioners have lacked good treatment options,” explained Lauren Krupp, (NYU Langone Health). “However, 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.

Sources: Charvet LE, Dobbs B, Shaw MT, Bikson M, Datta A, Krupp LB. Remotely supervised transcranial direct current stimulation for the treatment of fatigue in multiple sclerosis: Results from a randomized, sham-controlled trial. Mult. Scler.  doi:10.1177/1352458517732842 (2017) (Epub ahead of print);