Transcranial direct current stimulation (tDCS) for fatigue in multiple sclerosis
Transcranial direct current stimulation (tDCS) for fatigue in multiple sclerosis
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DOI：
10.3233/nre-131019
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发表时间：
2014-01-01
影响因子：
2
通讯作者：
Priori, Alberto
中科院分区：
文献类型：
--
作者：
Ferrucci, Roberta;Vergari, Maurizio;Priori, Alberto
背景技术背景：多发性硬化症（MS）患者在日常生活活动中经常经历的衰弱性疲劳对目前的治疗选择反应不佳。以弱强度通过头皮输送的直流电（DC）（经颅DC刺激或tDCS）引起运动皮层兴奋性的变化，这些变化在电流抵消后持续近一个小时，并取决于电流极性。tDCS成功地调节皮质兴奋性在各种临床疾病，但没有信息是MS相关fatigue.OBJECTIVE：在这项研究中，我们的目的是评估疲劳症状后，连续五届的阳极tDCS应用于运动皮层的MS患者。方法：我们招募了25例MS患者，他们都经历了疲劳。我们在两个独立的实验阶段中以随机顺序递送阳极和假tDCS，间隔至少1个月。刺激电流15 min，每日1次，连续5d。分别于治疗前（基线）、治疗后第5天（T1）、最后一次tDCS治疗后1周（T2）和3周（T3）进行疲劳影响量表（FIS）和背部抑郁量表（BDI）评定。65%的患者（应答者）在阳极tDCS后疲劳评分显著降低。患者接受tDCS治疗5 d后，FIS评分改善约30%，tDCS的益处在T2和T3持续存在。结论：我们的初步研究结果表明，在运动皮层上应用阳极tDCS，可以改善大多数MS患者的疲劳。
BACKGROUND: The debilitating fatigue that patients with multiple sclerosis (MS) commonly experience during day-to-day living activities responds poorly to current therapeutic options. Direct currents (DC) delivered through the scalp (transcranial DC stimulation or tDCS) at weak intensities induce changes in motor cortical excitability that persist for almost an hour after current offset and depend on current polarity. tDCS successfully modulates cortical excitability in various clinical disorders but no information is available for MS related fatigue.OBJECTIVE: In this study we aimed to assess fatigue symptom after five consecutive sessions of anodal tDCS applied over the motor cortex in patients with MS.METHODS: We enrolled 25 patients with MS all of whom experienced fatigue. We delivered anodal and sham tDCS in random order in two separate experimental sessions at least 1 month apart. The stimulating current was delivered for 15 minutes once a day for 5 consecutive days. In each session the Fatigue Impact Scale (FIS) and the Back Depression Inventory (BDI) were administered before the treatment (baseline), immediately after treatment on day five (T1), one week (T2) and three weeks (T3) after the last tDCS session.RESULTS: All patients tolerated tDCS well without adverse events. The fatigue score significantly decreased after anodal tDCS in 65% of the patients (responders). After patients received tDCS for 5 days their FIS scores improved by about 30% and the tDCS-induced benefits persisted at T2 and T3.CONCLUSION: Our preliminary findings suggest that anodal tDCS applied over the motor cortex, could improve fatigue in most patients with MS.