Laboratory of Electrophysiology for Translational neuroScience (LET'S) - ISTC - CNR, Rome, Italy.
Department of Geriatrics, Neurosciences & Orthopedics, Institute of Neurology, Catholic University of the Sacred Heart, Rome, Italy/Service of Medical Statistics and Information Technology, Fatebenefratelli Foundation for Health Research and Education, AFaR Division, Rome, Italy.
Mult Scler. 2018 Sep;24(10):1366-1374. doi: 10.1177/1352458517720528. Epub 2017 Jul 31.
The patients suffering from multiple sclerosis (MS) often consider fatigue the most debilitating symptom they experience, but conventional medicine currently offers poorly efficacious therapies.
We executed a replication study of an innovative approach for relieving MS fatigue.
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.
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.
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.
多发性硬化症（MS）患者常认为疲劳是他们所经历的最具致残性的症状，但目前常规医学提供的治疗方法效果不佳。
我们对一种缓解 MS 疲劳的创新方法进行了复制研究。
根据样本量估计，我们招募了 10 名疲劳的 MS 患者，他们在一项随机、双盲、假刺激对照、交叉研究中接受了为期 5 天的经颅直流电刺激（tDCS）治疗，以治疗结束时的改良疲劳影响量表（mFIS）评分降低为主要结局。一个个性化的阳极电极，根据磁共振成像（MRI）得出的个体皮质折叠形状，在双侧全身初级体感皮层（S1）上用一个枕部阴极进行靶向刺激。
与假刺激（基线的 14%）相比，真实刺激后的疲劳症状改善（40%）显著更大（p=0.012）。当疲劳相关症状严重影响 MS 患者的生活质量时，对轻度残疾的 MS 患者进行全身 S1 阳极刺激可显著减轻疲劳。
在独立的患者组中得到的第二个结果支持这样一种观点，即正确选择个性化靶标的神经调节干预可能是治疗 MS 疲劳的一种合适的非药物治疗方法。
