Journal
MULTIPLE SCLEROSIS JOURNAL
Volume 24, Issue 10, Pages 1366-1374Publisher
SAGE PUBLICATIONS LTD
DOI: 10.1177/1352458517720528
Keywords
Multiple sclerosis; fatigue; quality of life; transcranial direct current stimulation (tDCS); regional personalized electrode (RePE)
Categories
Funding
- FISM-Fondazione Italiana Sclerosi Multipla [2014/R/22]
- PNR-CNR Aging Program
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Background: The patients suffering from multiple sclerosis (MS) often consider fatigue the most debilitating symptom they experience, but conventional medicine currently offers poorly efficacious therapies. Objective: We executed a replication study of an innovative approach for relieving MS fatigue. Methods: According to the sample size estimate, we recruited 10 fatigued MS patients who received 5-day transcranial direct current stimulation (tDCS) in a randomized, double-blind, Sham-controlled, crossover study, with modified Fatigue Impact Scale (mFIS) score reduction at the end of the treatment as primary outcome. A personalized anodal electrode, shaped on the magnetic resonance imaging (MRI)-derived individual cortical folding, targeted the bilateral whole-body primary somatosensory cortex (S1) with an occipital cathode. Results: The amelioration of fatigue symptoms after Real stimulation (40% of baseline) was significantly larger than after Sham stimulation (14%, p=0.012). Anodal whole body S1 induced a significant fatigue reduction in mildly disabled MS patients when the fatigue-related symptoms severely hampered their quality of life. Conclusion: This second result in an independent group of patients supports the idea that neuromodulation interventions that properly select a personalized target might be a suitable non-pharmacological treatment for MS fatigue.
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