The Effect of Transcranial Direct Current Stimulation on Fatigue Among Multiple Sclerosis Patients.Patients
Study Details
Study Description
Brief Summary
This work is aimed to assess the long term effect of TDCS in fatigue management among MS patients
Condition or Disease | Intervention/Treatment | Phase |
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N/A |
Detailed Description
Multiple sclerosis (MS) is an inflammatory demyelinating disease of the central nervous system that is considered one of the most frequent causes of disability in the young adult.
Fatigue in MS may affect up to 80 % of the people with MS. It tends to persist over time once it appears. However, despite high frequency, fatigue remains poorly understood. Fatigue in MS is neither consistently linked to disease severity nor disease duration, although it is found to be worse in individuals with the secondary progressive subtype.
Fatigue is distinct from sleepiness, and fails to improve with adequate sleep. Multiple factors are thought to contribute to fatigue[7 , 8] with no specific biomarker or etiology yet confirmed.
A wide variety of therapies have been tested to reduce fatigue in MS, but unfortunately, none have been consistently effective. Transcranial direct current stimulation (tDCS) is a relatively recent therapeutic development that utilizes low-amplitude direct currents to induce changes in cortical excitability. Although various non-invasive neuromodulation technologies are available , tDCS has unique advantages compared to other stimulation methods such as its ease of use, lower cost, and greater safety and tolerability.
Small preliminary studies have observed that tDCS may be a promising treatment for MS fatigue, using sham-controlled crossover designs, with five tDCS sessions, using either a motor, sensory, or dorsolateral prefrontal cortex (DLPFC). Recently Chalah et al.[12] study demonstrated that DLPFC (left anodal) when compared the posterior parietal cortex led to the most fatigue specific improvements.
Thus, tDCS can reduce fatigue burden for people with MS, it may be possible to implement a tDCS therapy for symptomatic management of fatigue.
Study Design
Arms and Interventions
Arm | Intervention/Treatment |
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Experimental: experimental group Participants in the experimental groups received ten -sessions a-tDCS (1.5mA, 20minutes) anodal stimulation of left DLPC over two weeks duration (five sessions per week). |
Device: a-tDCS
Transcranial direct current stimulation
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Sham Comparator: sham group The sham group received ten sessions of sham stimulation for 20-minutes in each session. |
Device: a-tDCS
Transcranial direct current stimulation
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Outcome Measures
Primary Outcome Measures
- fatigue assessment scale [at post sessions, 1 month and 2 month post sessions]
it is a acale filed by the patient and it consists of scale from 1 to 10
- visual analogue scale [at post sessions, 1 month and 2 month post sessions]
it is a scale from 0 to 10 to assess major fatigue
Secondary Outcome Measures
- changes in cortical excitability parameters at post 10th session compared to baseline measurements of cortical excitability parameters [at post sessions, 1 month and 2 month post sessions]
Detection of the relationship between cortical excitability changes{after 10th session) and changes in fatigue and HDS and QLoL changes..
Eligibility Criteria
Criteria
Inclusion Criteria:
Any adult patient will be fulfilling diagnostic criteria of Multiple sclerosis and could be providing consent for participation in the study, will be included in the study.
Exclusion Criteria:
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any patient showed this following condition will be excluded from the study;
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Any MS patient had any contraindication condition to use TMS or TCDS (such as epilepsy, head trauma, metallic procedure, cerebral insult)
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Any patient had infection or febrile condition.
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Any patient had other co morbid neurological or psychiatric disorders or systemic disease.
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Any patient refuses participation in study.
Contacts and Locations
Locations
No locations specified.Sponsors and Collaborators
- Assiut University
Investigators
- Study Chair: Noha M Abo-Elfetoh, PHD, Assiut University
Study Documents (Full-Text)
None provided.More Information
Additional Information:
- Compston A, Coles A. Multiple sclerosis. Lancet.
- Tellez N et al. Fatigue in multiple sclerosis persists over time: a longitudinal study. J Neurol
- Krupp L. Fatigue is intrinsic to multiple sclerosis (MS) and is the most commonly reported symptom of the disease. Mult Scler
- Ghajarzadeh M, Jalilian R, Eskandari G, et al. Fatigue in multiple sclerosis: Relationship with disease duration, physical disability, disease pattern, age and sex. Acta Neurol Belg
- Chen MY, Wang EK, Jeng YJ. Adequate sleep among adolescents is positively associated with health status and health-related behaviors. BMC Public Health
- Genova HM, Rajagopalan V, Deluca J, et al. Examination of cognitive fatigue in multiple sclerosis using functional magnetic resonance imaging and diffusion tensor imaging. PLoS ONE.
- Saiote C, Goldschmidt T, Timaus C, et al. Impact of transcranial direct current stimulation on fatigue in multiple sclerosis. Restor Neurol Neurosci
- Generalizing remotely supervised transcranial direct current stimulation (tDCS): feasibility and benefit in Parkinson's disease
- Multi-session anodal transcranial direct current stimulation enhances lower extremity functional performance in healthy older adults
- Rating neurologic impairment in multiple sclerosis
- A Structured Interview Guide for the Hamilton Depression Rating Scale
Publications
None provided.- TCDCS in MS