Catarina Saiote1, Thomas Goldschmidt2, Charles Timäus1, Martijn D Steenwijk3, Alexander Opitz1, Andrea Antal1, Walter Paulus1, Michael A Nitsche1. 1. Department of Clinical Neurophysiology, University Medical Center, Georg-August University Göttingen, Göttingen, Germany. 2. Department of Clinical Neurophysiology, University Medical Center, Georg-August University Göttingen, Göttingen, Germany Department of Radiology and Nuclear Medicine, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands. 3. Department of Radiology and Nuclear Medicine, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands.
Abstract
PURPOSE: Fatigue is a frequent and difficult to treat symptom affecting patients with multiple sclerosis (MS) with a profound negative impact on quality of life. Fatigue has been associated with functional and structural abnormalities of the frontal cortex, including frontal hypo-activation. The aim of this exploratory study was to assess whether fatigue symptoms can be reduced by excitability-enhancing anodal transcranial direct current stimulation (tDCS). METHODS: In this sham-controlled, double-blind intervention study, tDCS was applied over the left prefrontal cortex of MS patients with fatigue for five consecutive days. Symptoms were tracked for 1 month via questionnaires. Lesion load at baseline was calculated for each patient and correlated with fatigue levels and responsiveness to stimulation. RESULTS: In the whole group analysis the scores of the fatigue scales were not altered by tDCS. However, in an exploratory analysis we found a correlation between response to the stimulation regarding subjectively perceived fatigue and lesion load in the left frontal cortex: patients responding positively to anodal tDCS had higher lesion load, compared to non-responding patients. CONCLUSION: We conclude that in patient subgroups discernible by specific morphological alterations, tDCS may be a tool for MS fatigue management.
RCT Entities:
PURPOSE:Fatigue is a frequent and difficult to treat symptom affecting patients with multiple sclerosis (MS) with a profound negative impact on quality of life. Fatigue has been associated with functional and structural abnormalities of the frontal cortex, including frontal hypo-activation. The aim of this exploratory study was to assess whether fatigue symptoms can be reduced by excitability-enhancing anodal transcranial direct current stimulation (tDCS). METHODS: In this sham-controlled, double-blind intervention study, tDCS was applied over the left prefrontal cortex of MSpatients with fatigue for five consecutive days. Symptoms were tracked for 1 month via questionnaires. Lesion load at baseline was calculated for each patient and correlated with fatigue levels and responsiveness to stimulation. RESULTS: In the whole group analysis the scores of the fatigue scales were not altered by tDCS. However, in an exploratory analysis we found a correlation between response to the stimulation regarding subjectively perceived fatigue and lesion load in the left frontal cortex: patients responding positively to anodal tDCS had higher lesion load, compared to non-responding patients. CONCLUSION: We conclude that in patient subgroups discernible by specific morphological alterations, tDCS may be a tool for MS fatigue management.
Authors: David A Cunningham; Daniel Janini; Alexandria Wyant; Corin Bonnett; Nicole Varnerin; Vishwanath Sankarasubramanian; Kelsey A Potter-Baker; Sarah Roelle; Xiaofeng Wang; Vlodek Siemionow; Guang H Yue; Ela B Plow Journal: Neuroscience Date: 2016-04-04 Impact factor: 3.590
Authors: Leigh E Charvet; Bryan Dobbs; Michael T Shaw; Marom Bikson; Abhishek Datta; Lauren B Krupp Journal: Mult Scler Date: 2017-09-22 Impact factor: 6.312