BACKGROUND: The patients suffering from multiple sclerosis (MS) often consider fatigue the most debilitating symptom they experience, but conventional medicine currently offers poorly efficacious therapies. OBJECTIVE: We executed a replication study of an innovative approach for relieving MS fatigue. METHODS: According to the sample size estimate, we recruited 10 fatigued MS patients who received 5-day transcranial direct current stimulation (tDCS) in a randomized, double-blind, Sham-controlled, crossover study, with modified Fatigue Impact Scale (mFIS) score reduction at the end of the treatment as primary outcome. A personalized anodal electrode, shaped on the magnetic resonance imaging (MRI)-derived individual cortical folding, targeted the bilateral whole-body primary somatosensory cortex (S1) with an occipital cathode. RESULTS: The amelioration of fatigue symptoms after Real stimulation (40% of baseline) was significantly larger than after Sham stimulation (14%, p = 0.012). Anodal whole body S1 induced a significant fatigue reduction in mildly disabled MS patients when the fatigue-related symptoms severely hampered their quality of life. CONCLUSION: This second result in an independent group of patients supports the idea that neuromodulation interventions that properly select a personalized target might be a suitable non-pharmacological treatment for MS fatigue.
Cancelli, A., Cottone, C., Giordani, A., Migliore, S., Lupoi, D., Porcaro, C., Mirabella, M., Rossini, P. M., Filippi, M. M., Tecchio, F., Personalized, bilateral whole-body somatosensory cortex stimulation to relieve fatigue in multiple sclerosis, <<MULTIPLE SCLEROSIS>>, 2017; (NA): 1-9. [doi:10.1177/1352458517720528] [http://hdl.handle.net/10807/111810]
Personalized, bilateral whole-body somatosensory cortex stimulation to relieve fatigue in multiple sclerosis
Cancelli, Andrea;Mirabella, Massimiliano;Rossini, Paolo Maria;
2017
Abstract
BACKGROUND: The patients suffering from multiple sclerosis (MS) often consider fatigue the most debilitating symptom they experience, but conventional medicine currently offers poorly efficacious therapies. OBJECTIVE: We executed a replication study of an innovative approach for relieving MS fatigue. METHODS: According to the sample size estimate, we recruited 10 fatigued MS patients who received 5-day transcranial direct current stimulation (tDCS) in a randomized, double-blind, Sham-controlled, crossover study, with modified Fatigue Impact Scale (mFIS) score reduction at the end of the treatment as primary outcome. A personalized anodal electrode, shaped on the magnetic resonance imaging (MRI)-derived individual cortical folding, targeted the bilateral whole-body primary somatosensory cortex (S1) with an occipital cathode. RESULTS: The amelioration of fatigue symptoms after Real stimulation (40% of baseline) was significantly larger than after Sham stimulation (14%, p = 0.012). Anodal whole body S1 induced a significant fatigue reduction in mildly disabled MS patients when the fatigue-related symptoms severely hampered their quality of life. CONCLUSION: This second result in an independent group of patients supports the idea that neuromodulation interventions that properly select a personalized target might be a suitable non-pharmacological treatment for MS fatigue.
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