Hsu Wan-Yu, Cheng Chia-Hsiung, Zanto Theodore P, Gazzaley Adam, Bove Riley M
Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States.
Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, Chang Gung University, Taoyuan, Taiwan.
Front Neurol. 2021 Mar 8;12:626113. doi: 10.3389/fneur.2021.626113. eCollection 2021.
The study aimed to evaluate the effects of transcranial direct current stimulation (tDCS) on cognition, mood disturbance, pain, and fatigue in people with multiple sclerosis (PwMS). A literature search was performed on articles published between January 1990 and May 2020 in Pubmed, Medline, and Web of Science using the following keywords and their abbreviation in combinations: multiple sclerosis and transcranial direct current stimulation. Mean effect size (ES) and 95% confidence interval were calculated for each domain of interest. Seventeen articles with a total of 383 PwMS were included in this analysis. For cognition, a strong effect size was found for the trial administering the Symbol Digit Modalities Test (ES: 1.15), whereas trials applying the Attention Network Test showed a negative effect size of -0.49. Moderate to strong effect sizes were observed for mood disturbance (mean ES: 0.92), pain (mean ES: 0.59), and fatigue (mean ES: 0.60). Further subgroup analyses for MS-related fatigue showed that both high and low intensities of stimulation lead to nearly the same degree of favorable effects. More pronounced effects were observed in studies administering the Fatigue Severity Scale compared with studies using other fatigue measures such as the Modified Fatigue Impact Scale. These results provide preliminary evidence that tDCS has a favorable effect on cognitive processing speed, mood disturbance, pain, and fatigue in MS. However, the effects on cognition and fatigue vary based on the specific assessment used.
该研究旨在评估经颅直流电刺激（tDCS）对多发性硬化症患者（PwMS）的认知、情绪障碍、疼痛和疲劳的影响。使用以下关键词及其缩写的组合，在1990年1月至2020年5月期间发表于PubMed、Medline和科学网的文章中进行了文献检索：多发性硬化症和经颅直流电刺激。计算了每个感兴趣领域的平均效应量（ES）和95%置信区间。本分析纳入了17篇文章，共383例PwMS患者。对于认知，在进行符号数字模态测试的试验中发现了较强的效应量（ES：1.15），而应用注意力网络测试的试验显示效应量为-0.49。在情绪障碍（平均ES：0.92）、疼痛（平均ES：0.59）和疲劳（平均ES：0.60）方面观察到中度至强烈的效应量。对与MS相关的疲劳进行的进一步亚组分析表明，高强度和低强度刺激产生的有益效果程度几乎相同。与使用其他疲劳测量方法（如改良疲劳影响量表）的研究相比，在使用疲劳严重程度量表的研究中观察到更明显的效果。这些结果提供了初步证据，表明tDCS对MS患者的认知加工速度、情绪障碍、疼痛和疲劳有有益影响。然而，对认知和疲劳的影响因所使用的具体评估方法而异。
