远程监督经颅直流电刺激治疗多发性硬化症疲劳：一项随机、假对照试验的结果。
Remotely supervised transcranial direct current stimulation for the treatment of fatigue in multiple sclerosis: Results from a randomized, sham-controlled trial.
机构信息
Department of Neurology, NYU Langone Medical Center, New York, NY, USA.
Department of Biomedical Engineering, The City University of New York, New York, NY, USA.
出版信息
Mult Scler. 2018 Nov;24(13):1760-1769. doi: 10.1177/1352458517732842. Epub 2017 Sep 22.
BACKGROUND
Fatigue is a common and debilitating feature of multiple sclerosis (MS) that remains without reliably effective treatment. Transcranial direct current stimulation (tDCS) is a promising option for fatigue reduction. We developed a telerehabilitation protocol that delivers tDCS to participants at home using specially designed equipment and real-time supervision (remotely supervised transcranial direct current stimulation (RS-tDCS)).
OBJECTIVE
To evaluate whether tDCS can reduce fatigue in individuals with MS.
METHODS
Dorsolateral prefrontal cortex left anodal tDCS was administered using a RS-tDCS protocol, paired with 20 minutes of cognitive training. Here, two studies are considered. Study 1 delivered 10 open-label tDCS treatments (1.5 mA; n = 15) compared to a cognitive training only condition ( n = 20). Study 2 was a randomized trial of active (2.0 mA, n = 15) or sham ( n = 12) delivered for 20 sessions. Fatigue was assessed using the Patient-Reported Outcomes Measurement Information System (PROMIS)-Fatigue Short Form.
RESULTS AND CONCLUSION
In Study 1, there was modest fatigue reduction in the active group (-2.5 ± 7.4 vs -0.2 ± 5.3, p = 0.30, Cohen's d = -0.35). However, in Study 2 there was statistically significant reduction for the active group (-5.6 ± 8.9 vs 0.9 ± 1.9, p = 0.02, Cohen's d = -0.71). tDCS is a potential treatment for MS-related fatigue.
背景
疲劳是多发性硬化症（MS）的一种常见且使人虚弱的特征，目前仍缺乏可靠有效的治疗方法。经颅直流电刺激（tDCS）是一种很有前途的减轻疲劳的选择。我们开发了一种远程康复方案，使用专门设计的设备和实时监控（远程监督经颅直流电刺激（RS-tDCS））在家中为参与者提供 tDCS。
目的
评估 tDCS 是否可以减轻 MS 患者的疲劳。
方法
使用 RS-tDCS 方案对左侧背外侧前额叶皮层进行左阳极 tDCS 治疗，同时进行 20 分钟的认知训练。这里考虑了两项研究。研究 1 提供了 10 个开放标签 tDCS 治疗（1.5 mA；n=15），与仅进行认知训练的条件（n=20）进行比较。研究 2 是一项主动（2.0 mA，n=15）或假（n=12）的随机试验，共进行 20 次。疲劳使用患者报告的结局测量信息系统（PROMIS）-疲劳简短形式进行评估。
结果和结论
在研究 1 中，活跃组的疲劳程度有适度减轻（-2.5±7.4 与-0.2±5.3，p=0.30，Cohen's d=-0.35）。然而，在研究 2 中，活跃组的疲劳程度有统计学显著减轻（-5.6±8.9 与 0.9±1.9，p=0.02，Cohen's d=-0.71）。tDCS 是治疗 MS 相关疲劳的一种潜在方法。
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