Efficacy of transcranial direct current stimulation in people with multiple sclerosis: a review

Abstract

Multiple sclerosis (MS) is a chronic disease of the central nervous system characterized by demyelination and neurodegeneration, leading to focal lesions in both the white and the grey matter [1].The underlying causes and mechanisms behind this chronic disease remain opaque. People with MS (PwMS) are faced with a wide range of symptoms, including disturbances of gait, coordination and vision, as well as pain, fatigue, depression and tremor [2]. Initially, the majority of PwMS present with a relapsing-remitting disease course, but

Efficacy of Transcranial Direct Current Stimulation (tDCS) on Balance and Gait in Multiple Sclerosis Patients: A Machine Learning Approach

“…The statistical analysis showed that exercise interventions moderately improved the walking distances immediately after the end of treatment, losing effect 4 and 6 weeks later. The addition of tDCS appeared to provide an ameliorative effect, with significant increases in the distances walked by patients in the experimental group at T1, as in a recent review [ 35 ], and significant increases in BBS for people with MS [ 75 ]. At 4 weeks after the end of the treatment, we found a loss of gain compared to T1, considering that it was significantly lower in the experimental group than in the control group.…”

“…Furthermore, a protocol of 10 sessions of stimulation associated with gait training represents the current reference, since it is clear that a small number of sessions has proven to be ineffective [ 34 , 35 , 36 ]. The immediate impact of tDCS is now well documented [ 40 ], although what is not well investigated is the persistence of this effect after the end of the stimulation itself.…”

“…Anodal tDCS determines improvements in gait parameters both during and after stimulation in people with MS [ 34 , 35 ]. Applied to the primary motor cortex (M1), it ameliorates motor performance, leading to synergistic effects when combined with a conventional rehabilitation treatment [ 36 , 37 ].…”

“…Applied to the primary motor cortex (M1), it ameliorates motor performance, leading to synergistic effects when combined with a conventional rehabilitation treatment [ 36 , 37 ]. Nevertheless, the exact influence of tDCS on gait in MS patients is mixed, being influenced by the degree of disability, the number of stimulation sessions and the type of parameters measured to define its effects [ 35 , 38 ]. Patients with MS with a low EDSS appear to benefit most from a combined treatment of neurostimulation and aerobic exercise and of a number of stimulation sessions that should be no less than 10 sessions [ 34 , 36 , 39 ].…”

Transcranial direct current stimulation for fatigue in neurological conditions: A systematic scoping review

“…Out of the 67 studies, 42 (63%) were interventional studies (Acler et al., 2012, 2013; Ayache et al., 2016, 2017; Bockbrader, 2017; Cancelli et al., 2018; Chalah et al., 2017a, 2017b, 2020; Chan et al., 2017; Charvet et al., 2018; Charvet & Shaw, 2017; De Doncker et al., 2021; Dobbs et al., 2017, 2018; Dong et al., 2021; Ferrucci et al., 2014; Fiene et al., 2018; Forogh et al., 2017; Gandiga et al., 2006; Hanken et al., 2016; Malik et al., 2016; Mortezanejad et al., 2020; Padalino et al., 2021; Pilloni et al., 2020; Porcaro et al., 2019a; Proessl et al., 2018; Saiote et al., 2014; Sbragia et al., 2020; Sharma et al., 2019, 2020; Shirvani et al., 2021; Sivaramakrishnan et al., 2019; Sun et al., 2022; Tecchio et al., 2014, 2015, 2022; Ulrichsen et al., 2022; Vannorsdall et al., 2015; Walton Masters et al., 2020; Workman et al., 2020, 2023), 18 (27%) were reviews (Ashrafi et al., 2020; Ayache and Chalah, 2017, 2018, 2019; Capone et al., 2020; Chalah et al., 2015; Hiew et al., 2022; Hsu et al., 2021; Iodice et al., 2017; Lefaucheur et al., 2017; Leocani et al., 2019; Linnhoff et al., 2019; Liu et al., 2019; Palm et al., 2014; Walker et al., 2019; Zaehle, 2021; Zielińska‐Now...…”