Cinbaz Gülser, Sarı Zübeyir, Oğuz Semra, Tombul Temel, Hanoğlu Lütfü, Fernández-Pérez Juan J, Gómez-Soriano Julio
Faculty of Health Sciences, Istanbul Medeniyet University, 34862 Istanbul, Turkey.
Faculty of Health Sciences, Marmara University, 34854 Istanbul, Turkey.
J Clin Med. 2024 Dec 14;13(24):7632. doi: 10.3390/jcm13247632.
Multiple Sclerosis (MS) is a chronic neurological condition that impairs motor and sensory functions, particularly gait. Non-invasive neuromodulation techniques aim to enhance functional recovery and motor-cognitive outcomes, though their effectiveness remains debated. This study compared the effects of transcranial direct current stimulation (tDCS) and trans-spinal direct current stimulation (tsDCS), combined with robotic-assisted gait training (RAGT), on motor function and fatigue in people with MS (pwMS). This double-blind, randomized, sham-controlled clinical trial included 35 pwMS, who participated in 12 sessions of 20 min anodal tDCS (n = 11), cathodal tsDCS (n = 12), or sham treatment (n = 12), in addition to RAGT. Primary outcomes were assessed using the Timed 25-foot Walk (T25-FW), Timed Up and Go (TUG), walking speed, and Multiple Sclerosis Walking Scale-12 (MSWS-12). Fatigue was assessed with the Fatigue Severity Scale (FSS) and the Fatigue Impact Scale (FIS). ClinicalTrials number: NCT06121635. Significant improvements in gait speed, T25-FW, MSWS-12, TUG scores, and fatigue (FSS) favored tDCS and tsDCS over sham stimulation. While no differences were found between tDCS and tsDCS, the tsDCS group showed a significant improvement in the FIS physical subscale compared to sham, unlike the tDCS group. tDCS and tsDCS, combined with RAGT, improve walking and reduce fatigue in pwMS, highlighting their potential in motor rehabilitation.
多发性硬化症（MS）是一种慢性神经疾病，会损害运动和感觉功能，尤其是步态。非侵入性神经调节技术旨在促进功能恢复和运动认知结果，但其有效性仍存在争议。本研究比较了经颅直流电刺激（tDCS）和经脊髓直流电刺激（tsDCS）联合机器人辅助步态训练（RAGT）对多发性硬化症患者（pwMS）运动功能和疲劳的影响。这项双盲、随机、假对照临床试验纳入了35名pwMS患者，他们除了接受RAGT外，还分别接受了12次每次20分钟的阳极tDCS（n = 11）、阴极tsDCS（n = 12）或假治疗（n = 12）。主要结局通过25英尺步行时间（T25 - FW）、起立行走测试（TUG）、步行速度和多发性硬化症步行量表12项（MSWS - 12）进行评估。疲劳通过疲劳严重程度量表（FSS）和疲劳影响量表（FIS）进行评估。临床试验编号：NCT06121635。与假刺激相比，tDCS和tsDCS在步态速度、T25 - FW、MSWS - 12、TUG评分和疲劳（FSS）方面有显著改善。虽然tDCS和tsDCS之间未发现差异，但与tDCS组不同，tsDCS组与假刺激相比，FIS身体亚量表有显著改善。tDCS和tsDCS联合RAGT可改善pwMS患者的步行能力并减轻疲劳，凸显了它们在运动康复中的潜力。
