Transcranial Direct Current Stimulation Is Feasible for Remotely Supervised Home Delivery in Multiple Sclerosis
Transcranial Direct Current Stimulation Is Feasible for Remotely Supervised Home Delivery in Multiple Sclerosis
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DOI：
10.1111/ner.12430
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发表时间：
2016-12-01
期刊：
影响因子：
2.8
通讯作者：
Charvet, Leigh E.
中科院分区：
文献类型：
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作者：
Kasschau, Margaret;Reisner, Jesse;Charvet, Leigh E.
目的：经颅直流电刺激（tDCS）在多发性硬化症（MS）的症状治疗中具有潜在的临床应用价值。为了充分评估治疗效果，反复的治疗是必要的。然而，对于许多多发性硬化症患者来说，每天去诊所接受治疗是不可行的，而且诊所的运送费用也很高。我们制定了一项研究协议，使用专门设计的设备和远程医疗平台远程监督tDCS家庭交付的自我或代理管理。材料和方法：我们的目标是在两周内进行10次治疗。20名被诊断为MS（任何亚型）的参与者（n=20），年龄30至69岁，残疾范围（扩展残疾状态量表或EDSS评分为1.0至8.0）被招募，以测试远程监督方案的可行性。结果：方案依从性超过了在临床治疗交付研究中观察到的，除了一名参与者（95%）外，所有参与者都完成了至少8个疗程。在192个有监督的疗程中，没有需要停药的疗程，也没有不良事件的报告。最常见的副作用是电极部位的瘙痒/刺痛。结论：这种远程监督tDCS方案为MS临床研究提供了一种安全可靠的tDCS方法，并扩大了患者使用tDCS的机会。
Objectives: Transcranial direct current stimulation (tDCS) has potential clinical application for symptomatic management in multiple sclerosis (MS). Repeated sessions are necessary in order to adequately evaluate a therapeutic effect. However, it is not feasible for many individuals with MS to visit clinic for treatment on a daily basis, and clinic delivery is also associated with substantial cost. We developed a research protocol to remotely supervise self-or proxy-administration for home delivery of tDCS using specially designed equipment and a telemedicine platform.Materials and Methods: We targeted ten treatment sessions across two weeks. Twenty participants (n=20) diagnosed with MS (any subtype), ages 30 to 69 years with a range of disability (Expanded Disability Status Scale or EDSS scores of 1.0 to 8.0) were enrolled to test the feasibility of the remotely supervised protocol.Results: Protocol adherence exceeded what has been observed in studies with clinic-based treatment delivery, with all but one participant (95%) completing at least eight of the ten sessions. Across a total of 192 supervised treatment sessions, no session required discontinuation and no adverse events were reported. The most common side effects were itching/tingling at the electrode site.Conclusions: This remotely supervised tDCS protocol provides a method for safe and reliable delivery of tDCS for clinical studies in MS and expands patient access to tDCS.