Charvet Leigh, Goldberg Judith D, Li Xiaochun, Best Pamela, Lustberg Matthew, Shaw Michael, Zhovtis Lana, Gutman Josef, Datta Abhishek, Bikson Marom, Pilloni Giuseppina, Krupp Lauren
Department of Neurology, NYU Grossman School of Medicine, 222 East 41st St., 10th Floor, New York, NY, 10017, USA.
Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA.
Sci Rep. 2025 Feb 7;15(1):4551. doi: 10.1038/s41598-025-88255-2.
Fatigue is a common and often debilitating feature of multiple sclerosis (MS) that lacks reliably effective treatment options for most patients. Transcranial direct current stimulation (tDCS), a safe and well-tolerated type of noninvasive brain stimulation, is a low-cost and home-based approach with the potential to reduce fatigue in MS. We conducted a double-blind, sham-controlled, randomized clinical trial to compare active vs. low-dose (sham) tDCS paired with computer-based cognitive training, delivered as a home-based intervention, to reduce MS-related fatigue. Participants with MS-related fatigue, but without depression, were stratified by neurologic disability using the Extended Disability Status Scale (EDSS) and randomized to complete 30 daily sessions over six weeks of either active or sham tDCS paired with online cognitive training (BrainHQ). The primary outcome was the change in PROMIS Fatigue score from baseline to the end of the intervention. A total of 117 participants were randomized, with 92% completing all treatment sessions. Both groups showed significant reductions in fatigue, with no significant difference between them. This suggests that tDCS does not provide any additional benefit over cognitive training alone in reducing fatigue, but confirms the feasibility and tolerance of this home-based intervention.
疲劳是多发性硬化症(MS)常见且往往使人衰弱的一个特征,对于大多数患者来说,缺乏可靠有效的治疗选择。经颅直流电刺激(tDCS)是一种安全且耐受性良好的非侵入性脑刺激方式,是一种低成本的居家治疗方法,有可能减轻MS患者的疲劳。我们进行了一项双盲、假刺激对照、随机临床试验,比较以居家干预方式进行的、与基于计算机的认知训练相结合的有源tDCS与低剂量(假刺激)tDCS,以减轻与MS相关的疲劳。患有与MS相关疲劳但无抑郁的参与者,使用扩展残疾状态量表(EDSS)按神经功能残疾程度分层,并随机分配在六周内每天完成30次有源或假刺激tDCS与在线认知训练(BrainHQ)相结合的治疗。主要结局是从基线到干预结束时患者报告结果测量信息系统(PROMIS)疲劳评分的变化。共有117名参与者被随机分组,92%完成了所有治疗疗程。两组的疲劳程度均显著降低,且两组之间无显著差异。这表明,在减轻疲劳方面,tDCS相比单独的认知训练没有提供任何额外益处,但证实了这种居家干预的可行性和耐受性。