Kasr Al-Ainy School of medicine, Cairo University, Cairo, Egypt.
Kasr Al-Ainy School of medicine, Cairo University, Cairo, Egypt.
Mult Scler Relat Disord. 2022 Nov;67:104191. doi: 10.1016/j.msard.2022.104191. Epub 2022 Sep 23.
Patients with Multiple sclerosis (MS) usually suffer from severe neurological disabilities. Spasticity is one of the most bothering and disabling manifestations that MS patients suffer from. Owing to being a chronic inflammatory demyelinating disorder; finding new modalities to alleviate some of the disabilities related to MS became a desired objective. Transcranial direct current stimulation (tDCS), a relatively new tool for modulating cortical excitability has been recently considered as a tool to provide symptomatic treatment for many neurologic and psychiatric diseases. In our study, we used tDCS to assess its effect on spasticity in MS patients.
5 consecutive daily sessions of 20 minutes duration of active anodal tDCS over the ipsilesional motor cortex were given to 10 relapsing remitting MS (RRMS) patients with at least 1 spastic lower limb (active group) who were compared with other matched10 RRMS patients who received sham stimulation (sham group). The outcome was to measure the effect on spasticity both clinically using the Modified Ashworth Scale (MAS) and through neurophysiological assessment (H reflex latency and H/M amplitude ratio).
Patients who received active anodal tDCS showed significant improvement (p< 0.05) in the H/M amplitude ratio as compared to the sham group. However, there was no significant difference between the two groups in the MAS. H latency showed significant stability in active group when compared to the sham group.
Anodal direct current stimulation of the ipsilesional motor cortex in patients with MS, resulted in reduced spasticity as per neurophysiological assessment.
多发性硬化症（MS）患者通常患有严重的神经功能障碍。痉挛是 MS 患者最困扰和致残的表现之一。由于多发性硬化症是一种慢性炎症性脱髓鞘疾病，寻找新的方法来减轻与 MS 相关的一些残疾成为一个理想的目标。经颅直流电刺激（tDCS）是一种调节皮质兴奋性的相对较新的工具，最近被认为是一种为许多神经和精神疾病提供症状治疗的工具。在我们的研究中，我们使用 tDCS 来评估其对 MS 患者痉挛的影响。
对 10 名至少有 1 条痉挛性下肢的复发缓解型多发性硬化症（RRMS）患者（主动组）进行连续 5 天，每天 20 分钟的同侧运动皮质阳极 tDCS 治疗，与接受假刺激的 10 名匹配 RRMS 患者（假刺激组）进行比较。结果是通过临床使用改良 Ashworth 量表（MAS）和神经生理学评估（H 反射潜伏期和 H/M 幅度比）来衡量对痉挛的影响。
与假刺激组相比，接受阳极 tDCS 治疗的患者 H/M 幅度比明显改善（p<0.05）。然而，两组间 MAS 无显著差异。与假刺激组相比，主动组的 H 潜伏期显示出显著的稳定性。
MS 患者同侧运动皮质的阳极直流电刺激导致神经生理学评估的痉挛减轻。
