Effects of left DLPFC versus right PPC tDCS on multiple sclerosis fatigue

Fatigue in multiple sclerosis – Insights into evaluation and management

“…While stimulation of bilateral sensory and/or motor cortices [56,222,223] resulted in significant fatigue improvement compared to sham, efficacy of the DLPFC stimulation showed discrepancy among studies. In fact, our team found a significant fatigue reduction following left prefrontal cortex stimulation [25]; but this was not the case in the work done by Saiote et al where the whole group analysis failed to document any difference between active and sham conditions [192]. These negative results might be explained by the lower stimulation intensity adopted in the latter trial compared to the former one (1 mA in Saiote et al study vs. 2 mA in Chalah et al study).…”

“…Interestingly, our team also compared the stimulation efficacy of two different cortical sites and demonstrated the superiority of the left prefrontal tDCS over that of the right PPC in fatigue reduction [25]. In fact, the latter did not result in any change in fatigue level.…”

“…However, the stimulation site differed among studies, in which the targets were chosen as follows: bilateral primary motor cortex [56], bilateral primary sensory cortex [222,223], bilateral sensorimotor cortex [223] left dorsolateral prefrontal cortex (DLPFC) [25,192], or right posterior parietal cortex (PPC) [25]. While stimulation of bilateral sensory and/or motor cortices [56,222,223] resulted in significant fatigue improvement compared to sham, efficacy of the DLPFC stimulation showed discrepancy among studies.…”

Remotely supervised transcranial direct current stimulation for the treatment of fatigue in multiple sclerosis: Results from a randomized, sham-controlled trial

“…26,27 The most recent study by Chalah et al 27 demonstrated that the DLPFC (left anodal) when compared the posterior parietal cortex led to the most fatigue-specific improvements. In addition, DLPFC tDCS has demonstrated benefit for fatigue in post-polio syndrome 28 and Parkinson’s disease 29 (with improvement specific to fatigue vs daytime sleepiness).…”

Fatigue and Affective Manifestations in Multiple Sclerosis—A Cluster Approach

“…In the setting of MS, few reports have shown promising effects of the left anodal prefrontal tDCS. Indeed, this intervention was found in some studies to significantly decrease fatigue severity when applied over the left DLPFC for 20 min [28]. Such antifatigue effects were only obtained when the sessions were repeated daily for five consecutive days [1,28].…”