L'Abbate Teresa, Dimitriou Nefeli K, Dimakopoulos George, Tecchio Franca, Nasios Grigorios
Department of Psychology, International Telematic University UniNettuno, 00186 Rome, Italy.
Laboratory of Electrophysiology for Translational Neuroscience (LET'S), Istituto di Scienze e Tecnologie della Cognizione, CNR, 00196 Rome, Italy.
Brain Sci. 2025 Jul 28;15(8):807. doi: 10.3390/brainsci15080807.
: Fatigue and cognitive impairment are common issues for People with Multiple Sclerosis (PwMS), affecting over 80% and 40-65%, respectively. The relationship between these two debilitating conditions is complex, with cognitive deficits exacerbating fatigue and vice versa. This study investigates the effects of a multimodal intervention combining cognitive rehabilitation and neuromodulation to alleviate fatigue and enhance cognitive performance in PwMS. : The research employed multiple baselines across the subjects in a Single-Case Experimental Design (mbSCED) with a cohort of three PwMS diagnosed with Relapsing-Remitting MS. The intervention protocol consisted of a baseline phase followed by a four-week treatment involving transcranial direct current stimulation (tDCS) and cognitive training using RehaCom software (version 6.9.0). Fatigue levels were measured using the modified Fatigue Impact Scale (mFIS), while cognitive performance was evaluated through standardized neuropsychological assessments. : The multimodal protocol exhibited high feasibility and acceptability, with no dropouts. Individual responsiveness outcomes varied, with two PwMS showing significant decreases in fatigue and improvements in cognitive performance, particularly in the trained domains. Their motor performance and quality of life also improved, suggesting that the treatment had indirect beneficial effects. : This study provides preliminary evidence for the potential benefits of integrating neuromodulation and cognitive rehabilitation as a personalized therapeutic strategy for managing fatigue and cognitive impairments in MS. Further research is needed to delineate the specific contributions of each intervention component and establish standardized protocols for clinical implementation. The insights gained may lead to more effective, tailored treatment options for PwMS.
疲劳和认知障碍是多发性硬化症患者（PwMS）常见的问题，分别影响超过80%和40 - 65%的患者。这两种使人衰弱的状况之间的关系很复杂，认知缺陷会加重疲劳，反之亦然。本研究调查了认知康复和神经调节相结合的多模式干预对缓解PwMS患者疲劳和提高认知表现的效果。
该研究在单病例实验设计（mbSCED）中对三名被诊断为复发缓解型多发性硬化症的PwMS患者采用了多基线法。干预方案包括一个基线期，随后是为期四周的治疗，包括经颅直流电刺激（tDCS）和使用RehaCom软件（版本6.9.0）进行的认知训练。使用改良疲劳影响量表（mFIS）测量疲劳水平，同时通过标准化神经心理学评估来评估认知表现。
多模式方案显示出高可行性和可接受性，没有患者退出。个体反应结果各不相同，两名PwMS患者的疲劳显著减轻，认知表现有所改善，特别是在训练的领域。他们的运动表现和生活质量也有所提高，这表明该治疗有间接的有益效果。
本研究为整合神经调节和认知康复作为管理MS患者疲劳和认知障碍的个性化治疗策略的潜在益处提供了初步证据。需要进一步研究来明确每种干预成分的具体贡献，并建立临床实施的标准化方案。所获得的见解可能会为PwMS患者带来更有效、更具针对性的治疗选择。
